Sexual dysfunction associated with protease inhibitor containing highly active antiretroviral treatment

AIDS. 2001 May 25;15(8):1019-23. doi: 10.1097/00002030-200105250-00010.

Abstract

Background: A high proportion of individuals receiving highly active antiretroviral treatment (HAART) complain of sexual dysfunction (SD), encompassing a lack of desire or erectile dysfunction.

Objective: To determine whether SD was associated with particular components of the HAART regimens and to identify risk factors for the development of SD in patients on HAART.

Methods: A survey among patients with HIV infection using an anonymous questionnaire was conducted in 10 European countries between December 1998 and December 1999. A total of 904 individuals currently receiving antiretroviral agents were included in the analyses.

Results: A decrease in sexual interest was significantly more frequently reported by subjects (men and women) using HAART containing protease inhibitors (PI) (308/766, 40%), compared with PI-naive patients (22/138, 16%; OR 3.55; 95% CI 2.15--5.89). In addition, a significantly larger number of PI-experienced men reported a decrease in sexual potency (216/628, 34%) compared with PI-naive men (12/99, 12%; OR 2.56; 95% CI 1.33--5.03). In multivariate analyses the following factors were associated with a decrease in sexual interest: a current PI-containing regimen, a history of a PI regimen, symptomatic HIV infection, age and homosexual contact as HIV transmission mode. Factors associated with a decrease in sexual potency were: current use of a PI-containing regimen, symptomatic HIV disease, age and the use of tranquillisers.

Conclusion: SD appears to be a common side-effect of HAART regimens containing a PI. The potential association between SD and other side-effects of HAART, such as lipodystrophy syndrome and neuropathy, should be investigated further.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antiretroviral Therapy, Highly Active / adverse effects
  • Erectile Dysfunction / chemically induced
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / transmission
  • HIV Protease Inhibitors / adverse effects*
  • HIV Protease Inhibitors / therapeutic use
  • Humans
  • Indinavir / adverse effects
  • Indinavir / therapeutic use
  • Male
  • Multivariate Analysis
  • Nelfinavir / adverse effects
  • Nelfinavir / therapeutic use
  • Prevalence
  • Risk Factors
  • Ritonavir / adverse effects
  • Ritonavir / therapeutic use
  • Sexual Dysfunctions, Psychological / chemically induced*
  • Sexual Dysfunctions, Psychological / epidemiology
  • Surveys and Questionnaires

Substances

  • HIV Protease Inhibitors
  • Indinavir
  • Nelfinavir
  • Ritonavir