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Sexual Dysfunction in Protease Inhibitor Recipients A. Colson*1, P. Sax1‚2, M. Keller3, R. Platt1‚2, and P. Choo1. 1Brigham and Women's Hosp., Boston, MA; 2Harvard Pilgrim Hlth. Care, Boston; and 3Mount Sinai Med. Ctr., New York, NY Intro: Sexual dysfunction may be a common problem among men with HIV-1 infection due to the combined effects of medical illness, drug therapy, and psychological factors. Herein we describe the epidemiology of sexual dysfunction in a cohort of men in a large managed care organization (MCO). Methods: All men (>18 yrs old) who received non-investigational protease inhibitor (PI) therapy prior to 12/1/98 were identified by screening the MCO's automated pharmacy database for dispensings of these agents. The full-text outpatient records of these individuals from 1/90 to 11/98 were reviewed to identify mention of sexual dysfunction, erectile difficulties, impotence, and loss of libido. Coded diagnoses of depression, diabetes, hypertension, alcohol abuse, and cirrhosis were ascertained from the automated medical record. Results: 274 adult male PI recipients were identified. During the study period, 29.2% of the cohort received indinavir, 25.6% saquinavir, 26.2% ritonavir, and 18.9% nelfinavir. 90 individuals (33%) had documentation of sexual dysfunction, 52 (58%) of whom presented after initiation of PI therapy. The rates of first presentation with sexual dysfunction before and after initiation of PI therapy were 2.6/100 person-years (95% CI=1.8-3.5) and 12.7/100 person-years (95% CI=9.5-16.7), respectively (rate ratio=5.0; 95% CI=3.3-7.5). Sexual dysfunction was also significantly associated with antecedent diagnoses of depression and diabetes (p<.1), but not age > 40 years, alcohol abuse, cirrhosis, or hypertension. The rate ratio of first presentation with sexual dysfunction after initiation of PI therapy relative to before initiation of PI therapy adjusted for depression, diabetes, and age was 3.0 (95% CI=0.9-9.8). Conclusion: Protease inhibitor therapy may be associated with sexual dysfunction in men. This hypothesis warrants further investigation. Key Words: Drug Toxicity, Protease Inhibitor, Sexual Dysfunction |
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© 7th
Conference on Retroviruses and Opportunistic Infections, |