CROI 2020 – Testosterone use in HIV-infected men conveys same cardiovascular risk seen in healthy men


  • Liz Scherer
  • Conference Reports
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Takeaway

  • HIV-infected men who have sex with men are prone to the same testosterone-related cardiovascular (CV) risk as uninfected men.

Why this matters

  • Monitor HIV patients closely for CV risk factors.
  • Consider interventions to lower CV risk, especially when recommending testosterone therapy to counteract HIV-related hypogonadism.

Key results

  • 300 participants, median age 51 years (40-70),~50% Caucasian, 41% at risk for cardiovascular disease (CVD).
  • 70% reported never using testosterone, 8% were former users, 7% started between baseline and repeat CT scans (initiation and 4.5 years later), 15% entered the study on testosterone and remained on it.
  • 81% had undetectable viral loads (
  • Median total testosterone=606 ng/dL.
  • Overall risk for significant coronary artery calcium (CAC) progression was twice as great among continuous testosterone users (P=0.03), and 2.4 times greater among new users (P=0.01) vs former users.
  • Risk for non-calcified plaque volume progression was >2 times higher among continuous users.
  • Lower baseline serum testosterone was associated with increased CAC progression risk.

Study design

  • Retrospective analysis of men enrolled in the 30-year Multicenter AIDS Cohort Study to assess relationship between HIV and AF/AFL, 2010-2013.
  • Funding: National Institutes of Health, Massachusetts General Hospital.

Limitations

  • Retrospective study.

 

Commentary

“Our findings are similar to those on subclinical atherosclerotic progression in trials of older men in the general population on testosterone therapy,” said Dr. Haberlen, adding that, “it would be prudent to monitor for cardiovascular risk factors and recommend interventions to lower cardiovascular risk among men with HIV or considering testosterone therapy.”