Lower Urinary Tract Symptoms in Men Living with Human Immunodeficiency Virus: A Case-control Study

Abstract

Objective: Human immunodeficiency virus (HIV)/acquired immune deficiency syndrome constitutes a global pandemic affecting populations worldwide. There's a gap in data regarding lower urinary tract symptoms (LUTS) among men living with HIV (MLWH) during the antiretroviral therapy era. The aim of this study is to evaluate the potential influence of HIV status on the presence of LUTS. Materials and Methods: Infectious Diseases and Clinical Microbiology Clinic, referred MLWH and HIV-negative men (control group) to Urology Clinic after their initial assessment. In both groups, International Consultation on Incontinence Questionnaire-Male Lower Urinary Tract Symptoms (ICIQ-MLUTS), International Prostate Symptom Score (IPSS), King's Healthcare Questionnaire, 8-item Overactive Bladder Questionnaire (OAB-V8), ICIQ-Short Form, Urogenital Distress Inventory 6 and 7 were used. The presence or absence of each LUTS was individually assessed. Results: A total of 95 males (51 MLWH and 44 HIV-negative controls) were included. Both groups exhibited similar perceptions of general health. Scores of ICIQ-MLUTS, (for both voiding and incontinence scores), IPSS, and OAB-V8 were higher in the MLWH group. There were statistically significant differences between ICIQ-MLUTS and IPSS scores. The MLWH group exhibited a higher frequency of all types of LUTS. Statistical significance was observed in hesitancy, intermittency, decrease in urine flow rate, and sensation of incomplete bladder emptying between the MLWH group and the control group. Conclusion: LUTS were more commonly observed among MLWH compared to HIV-negative individuals. MLWH had more symptoms related to the emptying phase, as evidenced by higher scores on the IPSS and ICIQ-LUTS. While the results did not achieve statistical significance, there was a trend indicating a higher likelihood of OAB among MLWH. Continuing to explore this correlation within larger prospective cohorts, including comprehensive information on sexual behaviors, sexually transmitted diseases, and urodynamic data, might offer insights into the pathophysiological basis of this correlation.