Update on acquired hypogonadism in men living with HIV: pathogenesis, clinic, and treatment

Hypogonadism is a frequent finding among men living with HIV (MLWH) and it seems to occur earlier in comparison the general male population. Although prevalence of hypogonadism MLWH has significantly lowered thanks advancements medical management, remains high if compared age-matched HIV-uninfected men, ranging from 13% 40% age group 20-60 years. Signs symptoms low serum testosterone (T) are cause concern since they non-specific, mild-to-moderate degree, often overlapping those infection per se . For these reasons, can be underestimated absence targeted laboratory blood examinations. With regard etiological factors involved T decrease, emerging evidence suggested functional nature MLWH, pointing out mutual relationship between sex steroids, health status, comorbidities, HIV-related factors. In agreement this hypothesis, therapeutic approach aiming at improving or reversing concomitant diseases through lifestyle changes (e.g. physical activity) rather than pharmacological treatment should theoretically considered. However, considering both patient’s barriers maintained overtime lack evidence-based data on efficacy normalizing therapy an option when other non-pharmacological interventions ineffective as well for all forms hypogonadism. From perspective, traditional management especially role supplementation, revised light probable by good balance benefits harmful. This narrative review presents overview current knowledge deepening driving taking part providing advice clinical approach, underlining importance individualized optimizing non-gonadal comorbidities thus avoiding over-, even unnecessary, T.