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ACTH and cortisol secretions in children with perinatal HIV-1 infection

R Lala1, E Palomba, P Matarazzo

  • 1Department of Pediatric Endocrinology, Regina Margherita Children's Hospital, Turin, Italy.

Pediatric AIDS and HIV Infection
|August 1, 1996
PubMed

Insights

In children with HIV-1 infection, serum cortisol and adrenocorticotropic hormone (ACTH) levels did not differ significantly from healthy children. Adrenal failure is a potential late complication in severely ill patients with human immunodeficiency virus.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Endocrinology

Background:

  • Perinatal HIV-1 infection can affect various endocrine functions.
  • The relationship between HIV-1, adrenal hormones, and immune status (CD4 cell count) requires further elucidation.

Purpose of the Study:

  • To investigate serum cortisol and adrenocorticotropic hormone (ACTH) levels in children with perinatally acquired HIV-1 infection.
  • To assess the correlation between these hormone levels, CD4 cell counts, and disease severity.
  • To evaluate the role of cortisol in HIV-1 pathogenesis and disease progression.

Main Methods:

  • Evaluated serum cortisol, ACTH, and CD4 cell counts in 25 perinatally HIV-1-infected children.
  • Classified patients into three groups based on clinical symptoms (asymptomatic, moderately symptomatic, severe).
  • Compared HIV-1-infected children with 126 age- and sex-matched healthy controls.

Main Results:

  • No significant differences in cortisol and ACTH levels were observed between HIV-1-infected children and controls, or among the different disease severity groups.
  • CD4 cell counts declined progressively with increasing disease severity.
  • No correlation was found between cortisol or ACTH levels and CD4 cell counts.

Conclusions:

  • Adrenal insufficiency is not a common early complication but may occur late in severely ill HIV-1-infected patients.
  • The findings do not support the hypothesis that cortisol-induced cytokine shifts mediate HIV-1 disease progression.

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