Important note: Information in this article was accurate in October 2000. The state of the art may have changed since the publication date.
Researchers in Boston, who conducted the study on metformin in PHAs we reported in this issue of TreatmentUpdate, have also been investigating the lipodystrophy syndrome in HIV+ women. They have found that some women with body shape changes may also have higher-than-normal levels of the hormone testosterone compared to other HIV+ women who use antiviral therapy but who do not have lipodystrophy. The researchers are not sure why this difference in hormone levels occurs, but their study was relatively small and their findings need to be confirmed in a larger study.
For their study, researchers enrolled 39 women, 23 of whom were HIV+ and 16 who were not infected. The subjects were divided into the following three groups:
Subjects who were abusing alcohol or other substances were not enrolled in this study.
Using a number of tests, the researchers found that women with lipodystrophy were more likely to have significantly elevated levels of testosterone compared to the other two groups of women in the study.
The precise cause of the higher-than-normal testosterone levels in some women in this study is not clear. The research team speculates that there may be several answers.
One possibility is that the women's ovaries and/or adrenal glands may have been producing the excess testosterone. These glands could have been stimulated by the high insulin levels that usually occur in people with the lipodystrophy syndrome. According to the researchers, a large proportion of HIV+ women had irregular menstrual periods. Since these women were not near the age of menopause, this finding increased the suspicion of researchers that the women's ovaries could have been dysfunctional.
Another possible cause for the high testosterone level is exposure to anti-HIV drugs. The researchers found that the longer women used protease inhibitors (but not other drugs), the greater the chance that their testosterone levels would be high.
Future research needs to be done to find out about the following factors:
1. Hadigan C, Corcoran C, Piecuch S, Rodriguez W, Grinspoon S. Hyperandrogenemia in human immunodeficiency virus-infected women with the lipodystrophy syndrome. J Clin Endocrinol Metab 2000 Oct;85(10):3544-50.
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