Effects of Testosterone Replacement in HIV Positive Women with Weight Loss

The objective of this study was to determine whether physiological testosterone replacement increases fat-free mass (FFM) and muscle strength, and contributes to weight maintenance in HIV-infected women with relative androgen deficiency and weight loss.

Fifty-two HIV-infected, medically stable women, 18-50 yr of age, with >5% weight loss over 6 months and testosterone level <33 ng/dL, were randomized into this double-blind, placebo-controlled trial of 24 weeks duration.

Subjects in the testosterone group applied testosterone patches twice weekly to achieve a nominal delivery of 300 microg testosterone over 24 h. Data were evaluable for forty-four women.

Serum average total and peak testosterone levels increased significantly in the testosterone group, but did not change in the placebo group. However, there were no significant changes in FFM (0.7 +/- 0.4 kg [testosterone] vs. 0.3 +/- 0.4 kg [placebo]), fat mass (0.3 +/- 0.7 kg [testosterone] vs. 0.6 +/- 0.7 kg [placebo]) or body weight (1.0 +/- 0.9 kg [testosterone] vs. 0.9 +/- 0.8 kg [placebo]) between the two treatment groups.

There were no significant changes in leg press strength, leg power, or muscle fatigability in either group.

Changes in quality of life, sexual function, cognitive function and Karnofsky performance scores did not differ significantly between the two groups. HDL cholesterol levels decreased significantly in the testosterone group. The patches were well tolerated.

The authors conclude, “We conclude that physiologic testosterone replacement was safe and effective in raising testosterone levels into mid- to high normal range, but did not significantly increase FFM, body weight or muscle performance in HIV-infected women with low testosterone levels and mild weight loss.”

“Further studies are needed to fully explore the role of androgens in the regulation of body composition in women.”

01/07/05

Reference
H Choi and others. Effects of Testosterone Replacement in HIV Positive Women with Weight Loss. Journal of Clincial Endochrinology and Metabolism. December 24, 2004 [Epub ahead of print].