Androgen and Anabolic Therapies in HIV

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Androgen and Anabolic Therapies in HIV

Slide Presentation
September 20, 2006
Donald Abrams, MD

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Slide 1.

Androgen and Anabolic Therapies in HIV

Slide 1.

Testosterone

Slide 2.

AIDS, Wasting, Hypogonadism

Slide 3.

Built to Survive

Slide 4.

Attention: Aging Men

Slide 5.

The Key to Great Sex

Slide 6.

Testosterone: Target Organs

Slide 7.

Production of Androgens from Cholesterol

Slide 8.

Production and Regulation of Testosterone

Slide 9.

Definition of Hypogonadism

Slide 10.

Causes of Hypogonadism

Slide 11.

Sustained-Action Oral Opioids

Slide 12.

Hypogonadism in the Aging Man

Slide 13.

Decreases in Plasma Testosterone Levels with Age

Slide 14.

Signs and Symptoms of Low Testosterone/Andropause

Slide 15.

Your penis shrinks 19.8% as you get older...

Slide 16.

Diagnostic Testosterone Testing: Initial Tests

Slide 17.

Diagnostic Testosterone Testing: Additional Tests

Slide 18.

Prevalence of Hypogonadism in HIV

Slide 19.

Controlled Trials of Testosterone Therapy in HIV+ Men

Slide 20.

Conflicting Reports on T's Effects

Slide 21.

IM Testosterone and/or Exercise In Eugonadal Men With AIDS Wasting

Slide 22.

IM Testosterone and/or Exercise In Eugonadal Men With AIDS Wasting

Slide 23.

IM Testosterone Therapy and Resistance Exercise in Hypogonadal HIV+ Men

Slide 24.

IM Testosterone Therapy and Resistance Exercise in Hypogonadal HIV+ Men

Slide 25.

Efficacy of TTD Patch (6 mg/day) in Treating HIV Hypogonadism/Wasting

Slide 26.

Efficacy of TTD Patch on HIV Hypogonadism (cont.)

Slide 27.

IM Testosterone In HIV-Associated Weight Loss

Slide 28.

IM Testosterone In HIV-Associated Weight Loss

Slide 29.

Testosterone Replacement and Mood Effects in Men Living With HIV

Slide 30.

Testosterone Replacement and Mood Effects in Men Living with HIV

Slide 31.

Goals and Benefits of Testosterone Replacement Therapy

Slide 32.

Slide 33.

Testosterone Therapy Delivery Systems

Slide 34.

Testosterone Therapy Delivery Systems: Dosing and Administration

Slide 35.

Testosterone Enanthate 250mg Administered IM Every 3 Weeks

Slide 36.

Normal Secretory Total Serum Testosterone Profiles in Healthy Young and Older Men

Slide 37.

Slide 38.

Testosterone (magazine cover)

Slide 39.

Testoderm TTS - Testosterone Transdermal System

Slide 40.

Testosterone Transdermal Patch Used on Nonscrotal Skin over 24 Hours

Slide 41.

Androgel (Testosterone gel)

Slide 42.

Testosterone Gel 1% Dosing

Slide 43.

Testosterone Therapy Delivery Systems: Adverse Effects

Slide 44.

Classification of Androgens

Slide 45.

Molecular Structures of Androgens in Clinical Use

Slide 46.

Structural-Potency Relationships of Commonly Used Anabolic-Androgenic Steroids (Animal Models)

Slide 47.

Nandralone in Dialysis Patients

Slide 48.

Nandralone in Dialysis Patients

Slide 49.

IM Anabolics in HIV

Slide 50.

Nandralone in Women with Weight Loss

Slide 51.

Oxandrolone Mechanism of Action

Slide 52.

Oxandrolone Trial: Preliminary Results from Baseline

Slide 53.

Anabolics and Body Habitus

Slide 54.

Monitoring Anabolic Steroid Therapy

Slide 55.

Anabolic Use in London Gyms

Slide 56.

Dehydroepiandrosterone and HIV: A Randomized Placebo-Controlled Study

Slide 57.

DHEA

Slide 58.

DHEA in the Testosterone Pathway

Slide 59.

Normal Function of DHEA

Slide 60.

DHEA Levels in HIV Infection

Slide 61.

DHEA and HIV Replication

Slide 62.

DHEA Trial Design

Slide 63.

DHEA Study Measurements

Slide 64.

DHEA Study Measurements

Slide 65.

DHEA Study

Slide 66.

Baseline Characteristics

Slide 67.

Baseline Characteristics

Slide 68.

Percent Change in Hormone Levels

Slide 69.

Estimated effects of DHEA on change in Log10 infectious units per million cells (mean and 95% CI)

Slide 70.

Effects of Immune Responsiveness

Slide 71.

DHEA Effects of Metabolism and Body Composition

Slide 72.

DHEA Affects on Mood and QOL

Slide 73.

DHEA and HIV: Conclusions

Slide 74.

Contraindications of Testosterone Replacement Therapy in Men

Slide 75.

Potential Risks of Testosterone Therapy

Slide 76.

Testosterone Therapy and Possible Prostate Changes

Slide 77.

Testosterone Use and Prostate Cancer

Slide 78.

Conclusions

Slide 79.

Major Unanswered Questions

Slide 80.