Study details
Researchers at a number of care facilities in Boston reviewed medical records of HIV positive men whose data were recorded between January 1993 and November 1998. In searching through the records, the researchers focused on 254 adult males who used protease inhibitors (PIs) and who had the following profile at the start of the study:
The following PIs were used by the proportion of subjects listed:
Importantly, some subjects also had pre-existing conditions which placed them at risk for sexual dysfunction, including the following:
Results
In reviewing their data, the researchers found that 32% of subjects had been diagnosed with sexual dysfunction. According to the data analysis, here are the key findings:
The major drawback of this study is that it involves looking back at information captured for a different purpose, in pre-existing medical records. This type of retrospective study is not as useful as a study designed from the outset to monitor the level of sexual dysfunction in subjects over time.
At the time the subjects would have been using ritonavir; in the late 1990s, the dose of this drug used would have been relatively high — as much as 1,200 mg daily. Currently, in North America, ritonavir is usually prescribed together with another protease inhibitor. In such cases, the dose of ritonavir is usually between 200 and 400 mg daily. It is not clear if these doses would still cause the same degree of sexual dysfunction reported in the Boston study.
This retrospective study found an association between the use of protease inhibitors and male sexual dysfunction. It is noteworthy that testosterone levels were only recorded in the medical records of 8 out of 254 subjects. Since less-than-normal levels of testosterone are not uncommon in HIV positive men, this lack of testosterone measurement is another possible limitation of the study. Perhaps the most useful outcome of this work is that it provides directions for better research into the causes of male sexual dysfunction in HAART users.
REFERENCE
1. Colson AE, Keller MJ, Sax PE, et al. Male sexual dysfunction associated with antiretroviral therapy. Journal of Acquired Immune Deficiency Syndromes 2002;30(1):27-32.
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