Most of my patients are co-infected. The ones with HIV become symptomatic hypogonadal and I replace their testosterone. In the monoinfected viral hepatitis pts I see symptomatic hypogonadism. Does this occur because the virus gets into the testis and causes them to fail? (I am assuming this is the case in HIV) or is their another mechanism involved? How long after initial HCV infection on average does hypogonadism show up in the lab work-up?
 
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I am not aware of any data on hcv infection and gonadal dysfunction - this is a difficult issue to separate from the hypogonadism that accompanies advanced liver disease.