1
|
Viruses and Endocrine Diseases. Microorganisms 2023; 11:microorganisms11020361. [PMID: 36838326 PMCID: PMC9967810 DOI: 10.3390/microorganisms11020361] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/27/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
Viral infections have been frequently associated with physiological and pathological changes in the endocrine system for many years. The numerous early and late endocrine complications reported during the current pandemic of coronavirus disease 2019 (COVID-19) reinforce the relevance of improving our understanding of the impact of viral infections on the endocrine system. Several viruses have been shown to infect endocrine cells and induce endocrine system disturbances through the direct damage of these cells or through indirect mechanisms, especially the activation of the host antiviral immune response, which may lead to the development of local or systemic inflammation or organ-specific autoimmunity. In addition, endocrine disorders may also affect susceptibility to viral infections since endocrine hormones have immunoregulatory functions. This review provides a brief overview of the impact of viral infections on the human endocrine system in order to provide new avenues for the control of endocrine diseases.
Collapse
|
2
|
Zhang Y, Lin F, Tu W, Zhang J, Choudhry AA, Ahmed O, Cheng J, Cui Y, Liu B, Dai M, Chen L, Han D, Fan Y, Zeng Y, Li W, Li S, Chen X, Shen M, Pan P. Thyroid dysfunction may be associated with poor outcomes in patients with COVID-19. Mol Cell Endocrinol 2021; 521:111097. [PMID: 33278491 PMCID: PMC7709789 DOI: 10.1016/j.mce.2020.111097] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/21/2020] [Accepted: 11/25/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Coronavirus disease (COVID-19) has resulted in considerable morbidity and mortality worldwide. Thyroid hormones play a key role in modulating metabolism and the immune system. However, the prevalence of thyroid dysfunction (TD) and its association with the prognosis of COVID-19 have not yet been elucidated. In this study, we seek to address this gap and understand the link between TD and COVID-19. METHODS Herein, we enrolled patients who were hospitalized with COVID-19 and had normal or abnormal thyroid function test results at the West Court of Union Hospital in Wuhan, China, between 29 January and February 26, 2020. We carried out follow up examinations until April 26, 2020. Data on clinical features, treatment strategies, and prognosis were collected and analyzed. TD was defined as an abnormal thyroid function test result, including overt thyrotoxicosis, overt hypothyroidism, subclinical hypothyroidism, subclinical hyperthyroidism, and euthyroid sick syndrome. RESULTS A total of 25 and 46 COVID-19 patients with and without TD, respectively, were included in the study. COVID-19 patients with TD had significantly higher neutrophil counts and higher levels of C-reactive protein, procalcitonin, lactate dehydrogenase, serum creatine kinase, aspartate transaminase, and high-sensitive troponin I and a longer activated partial thromboplastin time but lower lymphocyte, platelet, and eosinophil counts. A longitudinal analysis of serum biomarkers showed that patients with TD presented persistently high levels of biomarkers for inflammatory response and cardiac injury. COVID-19 patients with TD were more likely to develop a critical subtype of the disease. Patients with TD had a significantly higher fatality rate than did those without TD during hospitalization (20% vs 0%, P = 0.002). Patients with TD were more likely to stay in the hospital for more than 28 days than were those without TD (80% vs 56.52%, P = 0.048). CONCLUSIONS Our preliminary findings suggest that TD is associated with poor outcomes in patients with COVID-19.
Collapse
Affiliation(s)
- Yan Zhang
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Fengyu Lin
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Wei Tu
- Division of Allergy and Clinical Immunology, John Hopkins University School of Medicine, Baltimore, MD, 21224, USA
| | - Jianchu Zhang
- Department of Respiratory Medicine, Union Hospital of Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | | | - Omair Ahmed
- Ziauddin University, Clifton, Karachi, 75600, Pakistan
| | - Jun Cheng
- Department of Gastrointestinal Surgery& Breast& Thyroid Surgery, Changsha Hospital of Traditional Chinese Medicine, Changsha, Hunan, China
| | - Yanhui Cui
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Ben Liu
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Minhui Dai
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Lingli Chen
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Duoduo Han
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Yifei Fan
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Yanjun Zeng
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Wen Li
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Sha Li
- Department of Radiology, Xiangya Hospital, Central South University. Changsha, Hunan, 410008, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Minxue Shen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China; Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, 410008, China.
| | - Pinhua Pan
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
| |
Collapse
|
3
|
Huang IS, Mazur DJ, Kahn BE, Kate Keeter M, Desai AS, Lewis K, Tatem AJ, Hehemann MC, Brannigan RE, Bennett NE. Risk factors for hypogonadism in young men with erectile dysfunction. J Chin Med Assoc 2019; 82:477-481. [PMID: 30932936 DOI: 10.1097/jcma.0000000000000099] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The objective of this study is to evaluate the hormone profile of young men with the chief complaint of erectile dysfunction (ED) and determine the comorbidities in this population. METHODS A retrospective chart review of men aged 18 to 40 years who presented with ED and had a hormone evaluation but without prior medication for hormone manipulation from 2002 to 2016 was performed at a tertiary care institution. Data were obtained on demographics, comorbidities, medications, and hormonal evaluations. RESULTS A total of 2292 men with ED were identified and 2130 of them received testosterone level evaluation. The most common comorbidities that men were actively being treated for were depression (22.3%), anxiety (16.1%), hypertension (15.6%), diabetes (7.2%), cancer (6.2%), and cardiovascular disease (3.3%). The average total testosterone level was 368 ± 160 ng/dL; 10.7% of men had hypogonadism. Multivariate analysis demonstrated age, body mass index (BMI), depression, and cancer predicted a hypogonadal status. Patients with BMI > 28.2 kg/m, age > 34 years, cancer diagnosis, or depression were 3.350-fold, 1.447-fold, 2.317-fold, or 1.420-fold more likely to be diagnosed hypogonadal than nonoverweight, age ≤ 34 years, noncancer, or nondepressive patients. CONCLUSION The majority of men under the age of 40 with ED exhibit a normal hormonal milieu. Young ED men with BMI > 28.2 kg/m, age >34 years, cancer diagnosis, or depression are at risk for hypogonadism.
Collapse
Affiliation(s)
- I-Shen Huang
- Departments of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Urology, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Daniel J Mazur
- Departments of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Barbara E Kahn
- Departments of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Mary Kate Keeter
- Departments of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Anuj S Desai
- Departments of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kevin Lewis
- Departments of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Alexander J Tatem
- Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | - Marah C Hehemann
- Loyola Medicine Chicago Stritch School of Medicine, Chicago, Illinois, USA
| | - Robert E Brannigan
- Departments of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Nelson E Bennett
- Departments of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| |
Collapse
|
4
|
Akase IE, Habib AG, Bakari AG, Muhammad H, Gezawa ID. The prevalence and clinical profile of adrenocortical deficiency among HIV infected persons in Northern Nigeria. Afr Health Sci 2019; 19:1947-1952. [PMID: 31656478 PMCID: PMC6794548 DOI: 10.4314/ahs.v19i2.18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Infection with the human immune deficiency virus (HIV) is still a prevalent problem in Africa. Objectives The aim of this study was to determine the prevalence of hypocortisolism among patients with HIV and their clinical profile at Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Method Three hundred and fifty adult patients with HIV infection were recruited from the HIV clinic of AKTH, Kano. Blood samples for serum electrolytes, and cortisol both before and after the short Synacthen test were taken for estimation. Data were analyzed using the SPSS version 20.0 software. Results One hundred and eight (30.9%) of participants had low baseline serum cortisol levels, while 57 (16.3%) had a low serum cortisol after short synacthen test. There was no significant relationship between the cortisol levels and clinical features of hypocortisolism, WHO clinical stage of HIV, hypernatremia or HAART regimen. There was a negative correlation between the stimulated serum cortisol and duration of diagnosis of HIV, participants BMI and CD4 counts. Conclusion The biochemical evidence of hypocortisolism was common among patients infected with HIV, associated with a longer duration of HIV infection. However, none of CD4 counts, clinical features or HAART regimen were associated with hypocortisolism.
Collapse
|
5
|
Akase IE, Habib AG, Bakari AG, Muhammad H, Gezawa I, Nashabaru I, Iliyasu G, Mohammed AA. Occurrence of hypocortisolism in HIV patients: Is the picture changing? Ghana Med J 2019; 52:147-152. [PMID: 30602800 DOI: 10.4314/gmj.v52i3.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background The occurrence of endocrine diseases in people who are infected with HIV is traditionally thought to occur in the setting of AIDS with opportunistic infections and malignancies. However, recent studies find the correlation between hypocortisolism and stage of HIV (CD4 count and WHO clinical stage) inconsistent. Methods This descriptive cross-sectional study included three hundred and fifty (350) consecutive patients with HIV infection. They were interviewed, and subsequently underwent laboratory evaluation for the detection of hypocortisolism. Blood samples for serum cortisol estimation were taken at baseline and at 30 minutes following the administration of 1µg of tetracosactrin (Synacthen). In addition, the patients had blood samples taken at 0 minutes (baseline) for CD4+ lymphocyte cell counts. Results At baseline, 108 (30.9%) participants had serum cortisol levels below 100 µg/L with a median value of 55.48 µg/L (11.36-99.96 µg/L), but only 57 (16.3%) study participants had stimulated serum cortisol levels below 180 µg/L with median of 118 µg/L (19.43-179.62). There was no significant difference in the occurrence of clinical features between participants with low and normal serum cortisol, nor WHO clinical stage, CD4 count and ART regimen. The occurrence of hypocortisolism was higher among participants who had been on ART for a longer period of time. Conclusion There is a high prevalence of hypocortisolism among HIV patients by biochemical testing, especially those who have been on ARVs for a longer duration. Hypocortisolism cannot be predicted based on the participants' WHO clinical stage of disease, CD4 cell count, or the treatment regimen. Funding Personal Funds.
Collapse
Affiliation(s)
- Iorhen E Akase
- Infectious Disease unit, Lagos University teaching Hospital, Lagos, Nigeria
| | - Abdurazaq G Habib
- Infectious Disease unit, Bayero University; and Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Adamu G Bakari
- Endocrinology Unit, Ahmadu Bello University; and Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Hamza Muhammad
- Infectious Disease unit, Bayero University; and Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Ibrahim Gezawa
- Endocrinology Unit, Bayero University; and Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Ibrahim Nashabaru
- Infectious Disease unit, Bayero University; and Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Garba Iliyasu
- Infectious Disease unit, Bayero University; and Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Abdullahi A Mohammed
- Infectious Disease unit, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| |
Collapse
|
6
|
Brigante G, Riccetti L, Lazzaretti C, Rofrano L, Sperduti S, Potì F, Diazzi C, Prodam F, Guaraldi G, Lania AG, Rochira V, Casarini L. Abacavir, nevirapine, and ritonavir modulate intracellular calcium levels without affecting GHRH-mediated growth hormone secretion in somatotropic cells in vitro. Mol Cell Endocrinol 2019; 482:37-44. [PMID: 30543878 DOI: 10.1016/j.mce.2018.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/15/2018] [Accepted: 12/10/2018] [Indexed: 11/17/2022]
Abstract
Growth Hormone (GH) deficiency is frequent in HIV-infected patients treated with antiretroviral therapy. We treated GH3 cells with antiretrovirals (nevirapine, ritonavir or abacavir sulfate; 100 pM-1 mM range), after transfection with human growth hormone releasing hormone (GHRH) receptor cDNA. Cells viability, intracellular cAMP, phosphorylation of CREB and calcium increase, GH production and secretion were evaluated both in basal condition and after GHRH, using MTT, bioluminescence resonance energy transfer, western blotting and ELISA. Antiretroviral treatment did not affect GHRH 50% effective dose (EC50) calculated for 30-min intracellular cAMP increase (Mann-Whitney's U test; p ≥ 0.05; n = 4) nor 15-min CREB phosphorylation. The kinetics of GHRH-mediated, rapid intracellular calcium increase was perturbed by pre-incubation with drugs, while GHRH failed to induce the ion increase in ritonavir pre-treated cells (ANOVA; p < 0.05; n = 3). Antiretrovirals did not impact 24-h intracellular and extracellular GH levels (ANOVA; p ≥ 0.05; n = 3). We demonstrated the association between antiretrovirals and intracellular calcium increase, without consequences on somatotrope cells viability and GH synthesis. Overall, these results suggest that antiretrovirals may not directly impact on GH axis in HIV-infected patients.
Collapse
Affiliation(s)
- Giulia Brigante
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Medical Specialties, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Laura Riccetti
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Clara Lazzaretti
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Laura Rofrano
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Samantha Sperduti
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesco Potì
- Department of Medicine and Surgery - Unit of Neurosciences, University of Parma, Parma, Italy
| | - Chiara Diazzi
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Medical Specialties, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Flavia Prodam
- Unit of Paediatrics, Endocrinology, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Giovanni Guaraldi
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Andrea G Lania
- Endocrine Unit, IRCCS Humanitas Clinical Institute, Rozzano, Humanitas University, Rozzano, Italy
| | - Vincenzo Rochira
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Medical Specialties, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy.
| | - Livio Casarini
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Center for Genomic Research, University of Modena and Reggio Emilia, Modena, Italy
| |
Collapse
|
7
|
Affiliation(s)
- Eesh Bhatia
- Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226 014, Uttar Pradesh, India
| |
Collapse
|
8
|
Carrico AW, Rodriguez VJ, Jones DL, Kumar M. Short circuit: Disaggregation of adrenocorticotropic hormone and cortisol levels in HIV-positive, methamphetamine-using men who have sex with men. Hum Psychopharmacol 2018; 33:10.1002/hup.2645. [PMID: 29266420 PMCID: PMC5786481 DOI: 10.1002/hup.2645] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 10/28/2017] [Accepted: 11/17/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This study examined if methamphetamine use alone (METH + HIV-) and methamphetamine use in combination with HIV (METH + HIV+) were associated with hypothalamic-pituitary-adrenal (HPA) axis dysregulation as well as insulin resistance relative to a nonmethamphetamine-using, HIV-negative comparison group (METH-HIV-). METHODS Using an intact groups design, serum levels of HPA axis hormones in 46 METH + HIV- and 127 METH + HIV+ men who have sex with men (MSM) were compared to 136 METH-HIV- men. RESULTS There were no group differences in prevailing adrenocorticotropic hormone (ACTH) or cortisol levels, but the association between ACTH and cortisol was moderated by METH + HIV+ group (β = -0.19, p < .05). Compared to METH-HIV- men, METH + HIV+ MSM displayed 10% higher log10 cortisol levels per standard deviation lower ACTH. Both groups of methamphetamine-using MSM had lower insulin resistance and greater syndemic burden (i.e., sleep disturbance, severe depression, childhood trauma, and polysubstance use disorder) compared to METH-HIV- men. However, the disaggregated functional relationship between ACTH and cortisol in METH + HIV+ MSM was independent of these factors. CONCLUSIONS Further research is needed to characterize the bio-behavioral pathways that explain dysregulated HPA axis functioning in HIV-positive, methamphetamine-using MSM.
Collapse
Affiliation(s)
- Adam W. Carrico
- Department of Public Health Sciences, University of Miami, School of Medicine, Miami, Florida, USA
| | - Violeta J. Rodriguez
- Department of Psychiatry and Behavioral Sciences, University of Miami, School of Medicine, Miami, Florida, USA,Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Deborah L. Jones
- Department of Psychiatry and Behavioral Sciences, University of Miami, School of Medicine, Miami, Florida, USA
| | - Mahendra Kumar
- Department of Psychiatry and Behavioral Sciences, University of Miami, School of Medicine, Miami, Florida, USA
| |
Collapse
|
9
|
Luo L, Deng T, Zhao S, Li E, Liu L, Li F, Wang J, Zhao Z. Association Between HIV Infection and Prevalence of Erectile Dysfunction: A Systematic Review and Meta-Analysis. J Sex Med 2017; 14:1125-1132. [PMID: 28778576 DOI: 10.1016/j.jsxm.2017.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 06/06/2017] [Accepted: 07/02/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND The prevalence of erectile dysfunction (ED) in men positive for HIV has been reported to exceed the baseline of the general population. However, no meta-analysis or conclusive review has investigated whether individuals with HIV infection have a significantly higher prevalence of ED. AIM To explore the exact association between HIV infection and the prevalence of ED. METHODS The PubMed, Embase, Medline, and Cochrane Library databases were searched to identify studies concerning the association between HIV infection and the prevalence of ED that were published up to December 2016. Manual searches also were performed. Relative risks and corresponding 95% confidence intervals were used to estimate the strength of association between HIV infection and the prevalence of ED. The methodologic quality of the included cohort studies was assessed through the Newcastle-Ottawa Scale. The cross-sectional study quality methodology checklist was used to assess the quality of cross-sectional studies. Sensitivity analyses were conducted to assess potential bias. This study was conducted according to the guidelines for Meta-Analyses and Systematic Reviews of Observational Studies (MOOSE). OUTCOMES The strength of association between HIV infection and the prevalence of ED was evaluated using summarized unadjusted pooled relative risks and 95% confidence intervals. RESULTS Two cohort studies and three cross-sectional studies involving 4,252 participants were included. Mean age of patients ranged from 35.2 to 52 years in the included studies. Based on the random-effects model, analyses of all studies showed that HIV infection was significantly associated with an increased prevalence of ED (relative risk = 2.32, 95% confidence interval = 1.52-3.55, P < .001). There was significant heterogeneity among included studies (I2 = 84%, P < .001). Estimates of total effects were generally consistent with the sensitivity. CLINICAL IMPLICATIONS Individuals with HIV infection had a significantly increased prevalence of ED, which suggests that ED should be of concern to clinicians when managing men with HIV infection. STRENGTHS AND LIMITATIONS A strength of this study is that it is the first meta-analysis to explore the relation between HIV infection and the prevalence of ED. A limitation is that all included studies were observational studies, which can induce recall bias or selection bias. CONCLUSION Evidence from the observational studies suggested that individuals with HIV infection had a significantly increased prevalence of ED despite significant heterogeneity. More research is warranted to clarify the relation between HIV infection and the prevalence of ED. Luo L, Deng T, Zhao S, et al. Association Between HIV Infection and Prevalence of Erectile Dysfunction: A Systematic Review and Meta-Analysis. J Sex Med 2017;14:1125-1132.
Collapse
Affiliation(s)
- Lianmin Luo
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Tuo Deng
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Shankun Zhao
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Ermao Li
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Luhao Liu
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Futian Li
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jiamin Wang
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhigang Zhao
- Department of Urology and Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
| |
Collapse
|
10
|
de Menezes EGM, Machado AA, Barbosa F, de Paula FJA, Navarro AM. Bone metabolism dysfunction mediated by the increase of proinflammatory cytokines in chronic HIV infection. J Bone Miner Metab 2017; 35:234-242. [PMID: 27026434 DOI: 10.1007/s00774-016-0749-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 02/22/2016] [Indexed: 12/23/2022]
Abstract
Despite the efficacy of antiretroviral therapy (ART) on the control of viral replication, the current challenge is to decrease the chronic inflammatory status and toxicity of the antiretroviral drugs that contribute to increase the risk of metabolic complications. To verify the influence of proinflammatory cytokines on bone metabolism mediated by chronic HIV infection, a cross-sectional study was conducted with 50 HIV-infected adult men treated or not treated with ART. Dual energy X-ray absorptiometry (DXA) was performed to assess bone mineral density. Biochemical analysis were performed of IL-6, TNF-α, osteocalcin, PTH, 25-OH-D, total calcium, albumin, 24 h urinary calcium, and urinary deoxypyridinoline. The participants not treated with ART exhibited higher values of IL-6 and TNF-α than the participants treated with ART for more than 2 years. The TNF-α values were higher in the participants treated with ART for <2 years than in participants treated with ART for more than 2 years (p < 0.05). The increased values of urinary deoxypyridinoline indicated a high reabsorptive activity of bone tissue in all groups, with a significant difference between the participants not treated with ART and the participants treated with ART for <2 years. Through the DXA we found a bone mass reduction in all bone sites in each group. The increase in production of proinflammatory cytokines, most notably in the viremic group, demonstrated the ability to stimulate osteoclast activity and subsequently affect bone mass. The reduction of bone mineral density was observed in all bone sites, principally for the groups receiving antiretroviral treatment.
Collapse
Affiliation(s)
- Erika Grasiela Marques de Menezes
- Department of Food and Nutrition, Faculty of Pharmaceutical Sciences, University of São Paulo - UNESP, Araraquara, Brazil.
- , Avenida Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil.
| | - Alcyone Artioli Machado
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo - FMRP/USP, Ribeirao Preto, Brazil
| | - Fernando Barbosa
- Department of Clinical Analysis, Toxicological and Bromatology, Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo - FCFRP/USP, Ribeirao Preto, Brazil
| | | | - Anderson Marliere Navarro
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo - FMRP/USP, Ribeirao Preto, Brazil
| |
Collapse
|
11
|
Abstract
Treatment with highly active antiretroviral drugs (HAART) is associated with several endocrine and metabolic comorbidities. Pituitary growth hormone (GH) secretion seems to be altered in human immunodeficiency virus (HIV) infection, and about one-third of patients have biochemical GH deficiency (GHD). We undertake a historical review of the functioning of the GH/insulin-like growth factor-1 (IGF-1) axis in patients with acquired immunodeficiency syndrome, and provide an overview of the main changes of the GH/IGF-1 axis occurring today in patients with HIV. Both spontaneous GH secretion and GH response to provocative stimuli are reduced in patients with HIV infection, especially in those with HIV-related lipodystrophy. The role of fat accumulation on flattened GH secretion is discussed, together with all factors able to potentially interfere with the pituitary secretion of GH. Several factors contribute to the development of GHD, but the pathophysiologic mechanisms involved in the genesis of GHD are complex and not yet fully elucidated owing to the difficulty in separating the effects of HIV infection from those of HAART, comorbidities and body changes. An update on the putative mechanisms involved in the pathogenesis of altered GH secretion in these patients is provided, together with an overview on the therapeutic strategies targeting the GH/IGF-1 axis to counteract fat redistribution associated with HIV-related lipodystrophy. The clinical significance of GHD in the context of HIV infection is discussed. The administration of tesamorelin, a GH releasing hormone analogue, is effective in reducing visceral fat in HIV-infected patients with lipodystrophy. This treatment is promising and safer than treatment with high doses of recombinant human growth hormone, which has several side-effects.
Collapse
Affiliation(s)
- Vincenzo Rochira
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Medicine, Endocrinology, Metabolism and Geriatrics, Azienda USL of Modena, Modena, Italy.
| | - Giovanni Guaraldi
- HIV Metabolic Clinic, Infectious and Tropical Disease Unit, Department of Medical and Surgical Sciences for Adults and Children, University of Modena and Reggio Emilia, Modena, Italy
| |
Collapse
|
12
|
Prevalence and Influencing Factors of Thyroid Dysfunction in HIV-Infected Patients. BIOMED RESEARCH INTERNATIONAL 2016; 2016:3874257. [PMID: 27200374 PMCID: PMC4855012 DOI: 10.1155/2016/3874257] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 03/08/2016] [Accepted: 04/04/2016] [Indexed: 12/30/2022]
Abstract
Thyroid dysfunction is more common in human immunodeficiency virus (HIV) patients. But the effects of highly active antiretroviral therapy (HAART) and hepatitis B/C virus (HBV/HCV) coinfection on thyroid function is unclear. We retrospectively reviewed the data of 178 HIV patients and determined the prevalence of thyroid dysfunction and the relationship between thyroid hormone levels, CD4 cell count, HIV-1 duration, HAART duration/regimens, and HBV/HCV coinfection. Of the 178 patients, 59 (33.1%) had thyroid dysfunction, mostly hypothyroidism. Thyroid dysfunction was significantly more frequent in the HAART group (41/104, 39.4%) than in the HAART-naïve group (18/74, 24.3%; P < 0.05). The mean CD4 cell count was significantly lower in patients with hypothyroidism (372 ± 331/μL) than in the other patients (P < 0.05). The FT4 level was significantly lower in the HAART group than in the HAART-naïve group (1.09 ± 0.23 versus 1.20 ± 0.29 pg/mL, P < 0.05). FT3/FT4 levels were negatively related to HIV duration and FT3 levels were positively related to CD4 cell (P < 0.05). HBV patients had lower FT3 levels, while HCV patients had higher FT3 and FT4 levels (P < 0.05). Thyroid dysfunction is more common in HIV patients on HAART, mainly manifested as hypothyroidism. FT3/FT4 levels are correlated with HIV progression. HBV/HCV coinfection increases the probability of thyroid dysfunction.
Collapse
|
13
|
Sokalski KM, Chu J, Mai AY, Qiu AQ, Albert AYK, Zanet DL, Côté HCF, Maan EJ, Pick N, Prior JC, Money DM, Murray MCM. Endocrine abnormalities in HIV-infected women are associated with peak viral load - the Children and Women: AntiRetrovirals and Markers of Aging (CARMA) Cohort. Clin Endocrinol (Oxf) 2016; 84:452-62. [PMID: 26300027 DOI: 10.1111/cen.12881] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 07/31/2015] [Accepted: 08/14/2015] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To investigate the prevalence of endocrine disturbances in a group of HIV-positive (HIV+) women and to identify factors affecting presence of these disorders. To examine specifically whether cellular ageing, as measured by leukocyte telomere length (LTL), is correlated with the presence of endocrine disturbance. DESIGN A cross-sectional retrospective substudy of an ongoing prospective cohort study. PATIENTS Adult HIV+ (≥19 years) women enrolled in the CARMA (Children and Women: AntiRetrovirals and Markers of Aging) cohort study (N = 192). Prevalences of T2DM, glucose intolerance, dyslipidaemia, thyroid disorders, adrenal insufficiency, hypogonadism, primary ovarian insufficiency (POI), demographics, HIV and hepatitis C virus (HCV) infection status, baseline LTL, combined antiRetroviral therapy (cART) and substance exposures were collected. Statistical analysis included univariable followed by multivariable Poisson regression and step-wise reduction to refine the multivariable model. RESULTS Prevalence of any endocrine abnormality was 58% (dyslipidaemia 43%, glucose intolerance/T2DM 13%, thyroid disorders 15%). In multivariable analysis, age was associated with number and type (any, glucose, lipid) of abnormality, while increasing body mass index (BMI) was associated with number of diagnoses and with glucose metabolism disorders. Interestingly, peak HIV pVL ≥100 000 copies/ml was associated with any abnormality, total number of disorders and presence of a thyroid disorder, while any disorder, glucose abnormalities and dyslipidaemia were negatively associated with alcohol use. LTL was not associated with number or type of endocrine abnormalities in this study. CONCLUSION Further studies examining the relationship between duration and extent of exposure to HIV viraemia in relation to developing abnormal endocrine function are warranted.
Collapse
Affiliation(s)
- Kristen M Sokalski
- Department of Medicine, University of British Columbia (UBC), Vancouver, BC, Canada
| | - Jackson Chu
- Department of Medicine, University of British Columbia (UBC), Vancouver, BC, Canada
| | - Alice Y Mai
- Department of Medicine, University of British Columbia (UBC), Vancouver, BC, Canada
| | - Annie Q Qiu
- Department of Biochemistry and Molecular Biology, UBC, Vancouver, BC, Canada
- Oak Tree Clinic, BC Women's Hospital, Vancouver, BC, Canada
| | | | - DeAnna L Zanet
- Department of Pathology & Laboratory Medicine, UBC, Vancouver, BC, Canada
| | - Hélène C F Côté
- Women's Health Research Institute, Vancouver, BC, Canada
- Department of Pathology & Laboratory Medicine, UBC, Vancouver, BC, Canada
| | - Evelyn J Maan
- Oak Tree Clinic, BC Women's Hospital, Vancouver, BC, Canada
| | - Neora Pick
- Oak Tree Clinic, BC Women's Hospital, Vancouver, BC, Canada
- Women's Health Research Institute, Vancouver, BC, Canada
- Department of Medicine, Division of Infectious Disease, UBC, Vancouver, BC, Canada
| | - Jerilynn C Prior
- Department of Medicine, Division of Endocrinology, Centre for Menstrual Cycle and Ovulation Research, UBC, Vancouver, BC, Canada
| | - Deborah M Money
- Oak Tree Clinic, BC Women's Hospital, Vancouver, BC, Canada
- Women's Health Research Institute, Vancouver, BC, Canada
- Department of Obstetrics and Gynecology, UBC, Vancouver, BC, Canada
| | - Melanie C M Murray
- Oak Tree Clinic, BC Women's Hospital, Vancouver, BC, Canada
- Women's Health Research Institute, Vancouver, BC, Canada
- Department of Medicine, Division of Infectious Disease, UBC, Vancouver, BC, Canada
| |
Collapse
|
14
|
Abstract
INTRODUCTION Since the initial description of HIV and AIDS, monumental efforts have been made both in the developed and developing countries to devise strategies and medications to control the disease. The advent of highly active antiretroviral therapy has now meant that the diagnosis of HIV is no longer a life-sentence and compliant patients with HIV can expect life expectancy similar to their noninfected peers. Consequently new challenges have arisen in the management of benign conditions. AIM To provide an overview of the key conditions and issues that HIV/AIDS patients may present with to an andrological service. METHODS Using PubMed, we screened the literature for studies on common andrological conditions specifically pertaining to HIV and AIDS. MAIN OUTCOME MEASURES The urological manifestations of HIV/AIDS in men have been summarized in an attempt to provide a useful guide for sexual health practitioners dealing with HIV-positive men. RESULTS As a result of advancements in pharmaceuticals, life expectancy of men infected with HIV has improved almost to that of the general population in developed countries. Therefore, clinicians are faced with non-life-threatening urological problems that affect the quality of life of men with HIV. The majority of these problems can be managed easily, by adapting a "patient-centered" approach, instead of "disease-centered" algorithms. CONCLUSION With improved survival and understanding, patients with HIV/AIDS can and do expect to enjoy a healthy sex life. With appropriate counseling around safe sex and careful management with consideration for disease-specific issues as well as the influence of medical therapy, patients can achieve a good quality of life.
Collapse
Affiliation(s)
| | | | - Ege Can Serefoglu
- Bagcilar Training & Research Hospital, Department of Urology, Istanbul, Turkey.
| |
Collapse
|
15
|
Wang Q, Liu J, Ding H, Geng W, Xu J, Guo X, Sun A, Kang J, Li X, Li Y, Jiang Y, Shang H. Reduced bone mineral density among ART-naive male patients with HIV in China. Future Virol 2015. [DOI: 10.2217/fvl.15.51] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aims: To evaluate the prevalence and associated factors of reduced bone mineral density (BMD) among antiretroviral therapy (ART) naive HIV-infected male patients in China. Methods: We compared BMD between HIV-infected male patients and healthy controls. Risk factors of reduced BMD were studied using multivariable linear regression. Results: Reduced BMD rate of chronic HIV infection patients was higher. HIV infection was independently associated with decreased BMD after adjusting for demographic factors. Older age, lower BMI and men who have sex with men (MSM) were revealed as the risk factors of lower BMD in HIV-infected male patients. Conclusion: Reduced BMD rate of HIV-infected patients was high. Policies are needed for prevention and treatment.
Collapse
Affiliation(s)
- Qi Wang
- Key Laboratory of AIDS Immunology of National Health & Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, P. R. China
- Collaborative Innovation Center for Diagnosis & Treatment of Infectious Diseases, Hangzhou, China
| | - Jing Liu
- Key Laboratory of AIDS Immunology of National Health & Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, P. R. China
- Collaborative Innovation Center for Diagnosis & Treatment of Infectious Diseases, Hangzhou, China
| | - Haibo Ding
- Key Laboratory of AIDS Immunology of National Health & Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, P. R. China
- Collaborative Innovation Center for Diagnosis & Treatment of Infectious Diseases, Hangzhou, China
| | - Wenqing Geng
- Key Laboratory of AIDS Immunology of National Health & Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, P. R. China
- Collaborative Innovation Center for Diagnosis & Treatment of Infectious Diseases, Hangzhou, China
| | - Junjie Xu
- Key Laboratory of AIDS Immunology of National Health & Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, P. R. China
- Collaborative Innovation Center for Diagnosis & Treatment of Infectious Diseases, Hangzhou, China
| | - Xiaolin Guo
- Key Laboratory of AIDS Immunology of National Health & Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, P. R. China
- Collaborative Innovation Center for Diagnosis & Treatment of Infectious Diseases, Hangzhou, China
| | - Amy Sun
- Key Laboratory of AIDS Immunology of National Health & Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, P. R. China
- Collaborative Innovation Center for Diagnosis & Treatment of Infectious Diseases, Hangzhou, China
| | - Jing Kang
- Key Laboratory of AIDS Immunology of National Health & Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, P. R. China
- Collaborative Innovation Center for Diagnosis & Treatment of Infectious Diseases, Hangzhou, China
| | - Xiaolin Li
- Key Laboratory of AIDS Immunology of National Health & Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, P. R. China
- Collaborative Innovation Center for Diagnosis & Treatment of Infectious Diseases, Hangzhou, China
| | - Yushu Li
- Liaoning Provincial Key Laboratory of Endocrine Diseases, Department of Endocrinology & Metabolism, Institute of Endocrinology, The First Affiliated Hospital of China Medical University, Shenyang, P. R. China
| | - Yongjun Jiang
- Key Laboratory of AIDS Immunology of National Health & Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, P. R. China
- Collaborative Innovation Center for Diagnosis & Treatment of Infectious Diseases, Hangzhou, China
| | - Hong Shang
- Key Laboratory of AIDS Immunology of National Health & Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University, Shenyang, P. R. China
- Collaborative Innovation Center for Diagnosis & Treatment of Infectious Diseases, Hangzhou, China
| |
Collapse
|
16
|
Kaushik A, Yndart A, Jayant RD, Sagar V, Atluri V, Bhansali S, Nair M. Electrochemical sensing method for point-of-care cortisol detection in human immunodeficiency virus-infected patients. Int J Nanomedicine 2015; 10:677-85. [PMID: 25632229 PMCID: PMC4304596 DOI: 10.2147/ijn.s75514] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
A novel electrochemical sensing method was devised for the first time to detect plasma cortisol, a potential psychological stress biomarker, in human immunodeficiency virus (HIV)-positive subjects. A miniaturized potentiostat (reconfigured LMP91000 chip) interfaced with a microfluidic manifold containing a cortisol immunosensor was employed to demonstrate electrochemical cortisol sensing. This fully integrated and optimized electrochemical sensing device exhibited a wide cortisol-detection range from 10 pg/mL to 500 ng/mL, a low detection limit of 10 pg/mL, and sensitivity of 5.8 μA (pg mL)−1, with a regression coefficient of 0.995. This cortisol-selective sensing system was employed to estimate plasma cortisol in ten samples from HIV patients. The electrochemical cortisol-sensing performance was validated using an enzyme-linked immunosorbent assay technique. The results obtained using both methodologies were comparable within 2%–5% variation. The information related to psychological stress of HIV patients can be correlated with disease-progression parameters to optimize diagnosis, therapeutic, and personalized health monitoring.
Collapse
Affiliation(s)
- Ajeet Kaushik
- Center of Personalized Nanomedicine, Institute of Neuroimmune Pharmacology, Department of Immun ology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Adriana Yndart
- Center of Personalized Nanomedicine, Institute of Neuroimmune Pharmacology, Department of Immun ology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Rahul Dev Jayant
- Center of Personalized Nanomedicine, Institute of Neuroimmune Pharmacology, Department of Immun ology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Vidya Sagar
- Center of Personalized Nanomedicine, Institute of Neuroimmune Pharmacology, Department of Immun ology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Venkata Atluri
- Center of Personalized Nanomedicine, Institute of Neuroimmune Pharmacology, Department of Immun ology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Shekhar Bhansali
- BioMEMS Microsystems Laboratory, Department of Electrical and Computer Engineering, Florida International University, Miami, FL, USA
| | - Madhavan Nair
- Center of Personalized Nanomedicine, Institute of Neuroimmune Pharmacology, Department of Immun ology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| |
Collapse
|
17
|
Documento de consenso sobre alteraciones metabólicas y riesgo cardiovascular en pacientes con infección por el virus de la inmunodeficiencia humana. Enferm Infecc Microbiol Clin 2015; 33:40.e1-40.e16. [DOI: 10.1016/j.eimc.2014.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 06/18/2014] [Indexed: 01/20/2023]
|
18
|
Brigante G, Diazzi C, Ansaloni A, Zirilli L, Orlando G, Guaraldi G, Rochira V. Gender differences in GH response to GHRH+ARG in lipodystrophic patients with HIV: a key role for body fat distribution. Eur J Endocrinol 2014; 170:685-96. [PMID: 24536088 DOI: 10.1530/eje-13-0961] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Gender influence on GH secretion in human immunodeficiency virus (HIV)-infected patients is poorly known. DESIGN AND METHODS To determine the effect of gender, we compared GH response to GH-releasing hormone plus arginine (GHRH+Arg), and body composition in 103 men and 97 women with HIV and lipodystrophy. The main outcomes were IGF1, basal GH, GH peak and area under the curve (AUC) after GHRH+Arg, body composition, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). RESULTS Men had lower GH peak and AUC than women (P<0.001). Of the study population, 21% of women and 37% of men had biochemical GH deficiency (GHD; GH peak <7.5 μg/l). VAT-to-SAT ratio was higher in men than in women with GHD (P<0.05). Unlike women, VAT, SAT, and trunk fat were greater in men with GHD than in men without GHD. IGF1 was significantly lower in women with GHD than in women without GHD, but not in men. At univariate analysis, BMI, trunk fat mass, VAT, and total adipose tissue were associated with GH peak and AUC in both sexes (P<0.05). BMI was the most significant predictive factor of GH peak, and AUC at multiregression analysis. Overall, abdominal fat had a less pronounced effect on GH in females than in males. CONCLUSIONS These data demonstrate that GH response to GHRH+Arg is significantly lower in HIV-infected males than females, resulting in a higher percentage of GHD in men. Adipose tissue distribution more than fat mass per se seems to account for GH gender differences and for the alteration of GH-IGF1 status in these patients.
Collapse
Affiliation(s)
- Giulia Brigante
- Chair of Endocrinology and Metabolism, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | | | | | | | | | | | | |
Collapse
|
19
|
Maffezzoni F, Porcelli T, Karamouzis I, Quiros-Roldan E, Castelli F, Mazziotti G, Giustina A. Osteoporosis in Human Immunodeficiency Virus Patients - An Emerging Clinical Concern. EUROPEAN ENDOCRINOLOGY 2014; 10:79-83. [PMID: 29872469 DOI: 10.17925/ee.2014.10.01.79] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Accepted: 03/06/2014] [Indexed: 12/19/2022]
Abstract
The advent of highly active anti-retroviral therapy (HAART) has significantly improved the survival of human immunodeficiency virus (HIV)-infected patients transforming the HIV infection from a fatal illness into a manageable chronic disease. As the number of older HIV-infected individuals increases, several ageing-related co-morbidities including osteopenia/osteoporosis and fractures have emerged. Patients exposed to HIV infection and its treatment may develop fragility fractures with potential significant impact on quality of life and survival. However, the awareness of HIV-related skeletal fragility is still relatively low and most HIV-infected patients are not investigated for osteoporosis and treated with anti-osteoporotic drugs in daily clinical practice. This article reviews the literature data on osteoporosis and osteopenia in HIV infection, focusing on the pathophysiological, clinical and therapeutic aspects of fragility fractures.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Andrea Giustina
- Full Professor, Division of Endocrinology, Department of Clinical and Experimental Sciences, University of Brescia, Italy
| |
Collapse
|
20
|
Santi D, Brigante G, Zona S, Guaraldi G, Rochira V. Male sexual dysfunction and HIV--a clinical perspective. Nat Rev Urol 2014; 11:99-109. [PMID: 24394405 DOI: 10.1038/nrurol.2013.314] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Sexual dysfunction in men with HIV is often overlooked by clinicians owing to many factors, including the taboo of sexuality. The improved life expectancy of patients with HIV requires physicians to consider their general wellbeing and sexual health with a renewed interest. However, data on sexual dysfunction in those with HIV are scarce. Erectile dysfunction (ED) is the most common sexual dysfunction in men, with a prevalence of ∼30-50% and is frequent even in men <40 years of age. HIV infection itself is the strongest predictor of ED, and many factors related to the infection-fear of virus transmission, changes in body image, HIV-related comorbidities, infection stigma, obligatory condom use-all impair erectile function. The diagnosis and treatment of sexual dysfunction is based on a multidisciplinary approach, which involves specialists in both infectious diseases and sexual medicine. Particular attention should be paid to the promotion of safer sex in these patients. This Review, describes the issues surrounding sexual dysfunction in men with HIV and aims to provide clinical advice for the physician treating these patients.
Collapse
Affiliation(s)
- Daniele Santi
- Department of Biomedical, Metabolic and Neural Sciences, Section of Endocrinology, University of Modena & Reggio Emilia, Via Campi 287, 41125 Modena, Italy
| | - Giulia Brigante
- Department of Biomedical, Metabolic and Neural Sciences, Section of Endocrinology, University of Modena & Reggio Emilia, Via Campi 287, 41125 Modena, Italy
| | - Stefano Zona
- Metabolic Clinic, Infectious and Tropical Disease Unit, Department of Medicine and Medical Specialties, University of Modena & Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy
| | - Giovanni Guaraldi
- Metabolic Clinic, Infectious and Tropical Disease Unit, Department of Medicine and Medical Specialties, University of Modena & Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy
| | - Vincenzo Rochira
- Department of Biomedical, Metabolic and Neural Sciences, Section of Endocrinology, University of Modena & Reggio Emilia, Via Campi 287, 41125 Modena, Italy
| |
Collapse
|
21
|
Bons J, Moreau L, Lefebvre H. Adrenal disorders in human immunodeficiency virus (HIV) infected patients. ANNALES D'ENDOCRINOLOGIE 2013; 74:508-14. [DOI: 10.1016/j.ando.2013.09.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 09/17/2013] [Accepted: 09/17/2013] [Indexed: 01/14/2023]
|
22
|
Gibellini D, Borderi M, Clò A, Morini S, Miserocchi A, Bon I, Ponti C, Re MC. HIV-related mechanisms in atherosclerosis and cardiovascular diseases. J Cardiovasc Med (Hagerstown) 2013; 14:780-90. [DOI: 10.2459/jcm.0b013e3283619331] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
23
|
Dyslipidemia and fasting glucose impairment among HIV patients three years after the first antiretroviral regimen in a Brazilian AIDS outpatient clinic. Braz J Infect Dis 2013; 17:438-43. [PMID: 23735423 PMCID: PMC9428045 DOI: 10.1016/j.bjid.2012.12.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Revised: 11/30/2012] [Accepted: 12/03/2012] [Indexed: 11/20/2022] Open
Abstract
Objective To evaluate the cumulative incidence of dyslipidemia and fasting glucose impairment three years after initiating the first antiretroviral (ART) regimen and the association with the type of ART regimen in an AIDS outpatient clinic in Brazil. Methods Retrospective cohort of HIV-1 infected patients attending an outpatient HIV clinic in Vitoria, Brazil, between January/2010 and May/2011. Data, including blood pressure, dyslipidemia (high total cholesterol and low HDL-C), fasting glucose, and cardiovascular risk by Framingham Risk Score were abstracted from medical records from clinic visits six months prior and three years after starting ART. We assessed independent associated factors for dyslipidemia using multiple logistic regression. Results Four hundred and ninety-eight patients on ART were studied. Median age was 45 years (interquartile range (IQR): 37–52), and median time since HIV diagnosis was 7.7 years (IQR: 3.8–10.0). The proportion of patients with dyslipidemia was 22.3% (95% CI: 18.6–25.9%) 36 months after ART initiation. Triglycerides levels >150 mg/dL (55.2% vs. 25.4%, p = 0.021) and high fasting glucose (5.8% vs. 2.3%, p = 0.034) were diagnosed more frequently after ART use when compared to baseline values. Multiple logistic regression analysis has shown dyslipidemia to be associated with lopinavir/r use [OR = 1.74 (95% CI: 1.12–2.86)]. Conclusion These data show high chance of dyslipidemia after initiation of ART. Long-term follow-up will help identify the impact of ART on cardiovascular risk.
Collapse
|
24
|
Chereshnev VA, Bocharov G, Bazhan S, Bachmetyev B, Gainova I, Likhoshvai V, Argilaguet JM, Martinez JP, Rump JA, Mothe B, Brander C, Meyerhans A. Pathogenesis and treatment of HIV infection: the cellular, the immune system and the neuroendocrine systems perspective. Int Rev Immunol 2013; 32:282-306. [PMID: 23617796 DOI: 10.3109/08830185.2013.779375] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Infections with HIV represent a great challenge for the development of strategies for an effective cure. The spectrum of diseases associated with HIV ranges from opportunistic infections and cancers to systemic physiological disorders like encephalopathy and neurocognitive impairment. A major progress in controlling HIV infection has been achieved by highly active antiretroviral therapy (HAART). However, HAART does neither eliminate the virus reservoirs in form of latently infected cells nor does it completely reconstitute immune reactivity and physiological status. Furthermore, the failure of the STEP vaccine trial and the only marginal efficacies of the RV144 trial together suggest that the causal relationships between the complex sets of viral and immunological processes that contribute to protection or disease pathogenesis are still poorly understood. Here, we provide an up-to-date overview of HIV-host interactions at the cellular, the immune system and the neuroendocrine systems level. Only by integrating this multi-level knowledge one will be able to handle the systems complexity and develop new methodologies of analysis and prediction for a functional restoration of the immune system and the health of the infected host.
Collapse
Affiliation(s)
- V A Chereshnev
- Institute of Immunology and Physiology, Ural Branch RAS, Ekaterinburg, Russia.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Gibellini D, Miserocchi A, Tazzari PL, Ricci F, Clò A, Morini S, Ponti C, Pasquinelli G, Bon I, Pagliaro P, Borderi M, Re MC. Analysis of the effects of HIV-1 Tat on the survival and differentiation of vessel wall-derived mesenchymal stem cells. J Cell Biochem 2012; 113:1132-41. [PMID: 22095559 DOI: 10.1002/jcb.23446] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
HIV infection is an independent risk factor for atherosclerosis development and cardiovascular damage. As vessel wall mesenchymal stem cells (MSCs) are involved in the regulation of vessel structure homeostasis, we investigated the role of Tat, a key factor in HIV replication and pathogenesis, in MSC survival and differentiation. The survival of subconfluent MSCs was impaired when Tat was added at high concentrations (200-1,000 ng/ml), whereas lower Tat concentrations (1-100 ng/ml) did not promote apoptosis. Tat enhanced the differentiation of MSC toward adipogenesis by the transcription and activity upregulation of PPARγ. This Tat-related modulation of adipogenesis was tackled by treatment with antagonists of Tat-specific receptors such as SU5416 and RGD Fc. In contrast, Tat inhibited the differentiation of MSCs to endothelial cells by downregulating the expression of VEGF-induced endothelial markers such as Flt-1, KDR, and vWF. The treatment of MSCs with Tat-derived peptides corresponding to the cysteine-rich, basic, and RGD domains indicated that these Tat regions are involved in the inhibition of endothelial marker expression. The Tat-related impairment of MSC survival and differentiation might play an important role in vessel damage and formation of the atherosclerotic lesions observed in HIV-infected patients.
Collapse
Affiliation(s)
- Davide Gibellini
- Microbiology Section, Department of Haematology and Oncological Sciences, University of Bologna, Bologna, Italy.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Current World Literature. Curr Opin Oncol 2012; 24:345-9. [DOI: 10.1097/cco.0b013e328352df9c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
27
|
Zirilli L, Orlando G, Carli F, Madeo B, Cocchi S, Diazzi C, Carani C, Guaraldi G, Rochira V. GH response to GHRH plus arginine is impaired in lipoatrophic women with human immunodeficiency virus compared with controls. Eur J Endocrinol 2012; 166:415-24. [PMID: 22189998 DOI: 10.1530/eje-11-0829] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE GH secretion is impaired in lipodystrophic human immunodeficiency virus (HIV) patients and inversely related to lipodystrophy-related fat redistribution in men. Less is known about the underlying mechanisms involved in reduced GH secretion in HIV-infected women. DESIGN A case-control, cross-sectional study comparing GH/IGF1 status, body composition, and metabolic parameters in 92 nonobese women with HIV-related lipodystrophy and 63 healthy controls matched for age, ethnicity, sex, and body mass index (BMI). METHODS GH, IGF1, IGF binding protein 3 (IGFBP3), GH after GHRH plus arginine (GHRH+Arg), several metabolic variables, and body composition were evaluated. RESULTS GH response to GHRH+Arg was lower in HIV-infected females than in controls. Using a cutoff of peak GH ≤ 7.5 μg/l, 20.6% of HIV-infected females demonstrated reduced peak GH response after GHRH+Arg. In contrast, none of the control subjects demonstrated a peak GH response ≤ 7.5 μg/l. Bone mineral density (BMD), quality of life, IGF1, and IGFBP3 were lowest in the HIV-infected females with a GH peak ≤ 7.5 μg/l. BMI was the main predictive factor of GH peak in stepwise multiregression analysis followed by age, with a less significant effect of visceral fat in the HIV-infected females. CONCLUSIONS This study establishes that i) GH response to GHRH+Arg is lower in lipoatrophic HIV-infected women than in healthy matched controls, ii) BMI more than visceral adipose tissue or trunk fat influences GH peak in this population, and iii) HIV-infected women with a GH peak below or equal to 7.5 μg/l demonstrate reduced IGF1, IGFBP3, BMD, and quality of life.
Collapse
Affiliation(s)
- Lucia Zirilli
- Integrated Department of Medicine, University of Modena and Reggio Emilia, Via Giardini 1355, 41100 Modena, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|