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Adrenocortical function in Nigerians with human immunodeficiency virus infection
I A Odeniyi1, O A Fasanmade1, M O Ajala2
1Department of Medicine, College of Medicine, University of Lagos, PMB 12003, Surulere, Lagos, Nigeria.
Ghana Medical Journal
|March 27, 2014
Summary
Adrenocortical insufficiency affects 34.8% of people with HIV, as shown by a low-dose ACTH stimulation test. Clinically apparent adrenal insufficiency is rare in this population.
Area of Science:
- Endocrinology
- Infectious Diseases
- HIV/AIDS Research
Background:
- Adrenocortical insufficiency is a potential complication in individuals with Human Immunodeficiency Virus (HIV) infection.
- Early detection and management are crucial for improving patient outcomes.
Purpose of the Study:
- To determine the prevalence of adrenocortical insufficiency in HIV-infected individuals.
- To assess the response to low-dose (1 µg) ACTH stimulation in this population.
Main Methods:
- An experimental study was conducted involving 43 treatment-naïve HIV-positive individuals and 70 HIV-negative controls.
- A low-dose (1 µg) ACTH stimulation test was administered intravenously.
- Basal and 30-minute post-ACTH cortisol levels were measured using ELISA.
Main Results:
- Fifteen (34.8%) HIV-positive individuals exhibited signs of adrenal insufficiency based on derived diagnostic criteria.
- Significant differences in basal cortisol, 30-minute post-ACTH cortisol, and cortisol increment were observed between HIV-positive and healthy subjects (p<0.001).
Conclusions:
- Adrenocortical insufficiency is a common finding in HIV-infected individuals, with a prevalence of 34.8% in the studied cohort.
- Despite the high prevalence of subclinical insufficiency, clinically evident adrenocortical insufficiency is uncommon in persons with HIV.
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