Reproductive Hormones And Testicular Histology In Males With Human Immunodeficiency Virus Infection
Busingye, Bazare R.
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Reproductive endocrine dysfunction and abnormalities of testicular histology have been described in men with Human Immunodeficiency Virus (HIV) infection and Acquired Immunodeficiency Syndrome (AIDS). This has mainly been among homosexual drug abusing men in the United States and Europe. The objective of this study was to study the changes that occur in male reproductive hormones and testicular histology in Ugandan black heterosexual non-drug abusing HIV infected men. Eighty seven men, 25 HIV negative (controls) and 62 HIV positive (cases) were studied. Of the HIV positive men, five, eighteen, twenty nine and ten were in the WHO Clinical stage 1,2,3 and 4 respectively. Blood samples were obtained from these subjects and serum follicle stimulating hormone (FSH) luteinising hormone (LH), and prolactin were measured by Enzyme Immuno Assay while testosterone and cortisol were measured by radioimmunoassay. The right testis was also obtained at postmortem from 30 males for histology. Fifteen of these were HIV positive (cases) and 15 were HIV negative (controls). Seven of the HIV negative had died from traumatic causes. Sections of the upper, middle and lower poles of the testis were prepared and stained with haernatoxylln and eosin and mansoni stain for collagen, after which they were examined by light microscopy. . When the cases and controls were compared, the mean serum testosterone was statistically significantly lower in the HIV positive group (13.6 ± 7.4 m moUl) than in the HIV negative group (18.7 ± 7.8 mmol/L). Hypogonadism was also commoner in the cases (48%) than the control group (20%). Diminished libido and impotence were also more prevalent in the HIV positive group (46.8%) than the HIV negative group, (8.0%). Serum FSH was higher in the HIV cases (6.1 ± 6.6 iu/I) than the controls (2.7 ± 2.2 Lull). However, LH was unaltered. Serum cortisol and prolactin were lower in the HIV positive group than the HIV negative group. Testicular histology showed abnormal spermatogenesis in 60% of those with HIV infection whereas all those t,hat were HIV negative and had died due to traumatic causes had normal spermatogenesis. Spermatogenesis was commonly arrested at the spermatocyte and spermatogonia stage with a few tubules lined with Sertoli cells only. Sixty seven percent of the tubules had a thickened basement membrane. However, .the Leydig cells and the interstitium were generally unaltered. ~ In Uganda as elsewhere, men with AIDS show a disrupted spermatogenic process and hypogonadism in common. However, low serum prolactin and cortisol found in this study are in disagreement with studies done elsewhere where these were normal or raised in HIV infection and AIDS.