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Related Experiment Videos

Adrenal function in HIV infected patients.

B Verges1, P Chavanet, J Desgres

  • 1Department of Endocrinology, Hôpital du Bocage, University of Dijon, France.

Acta Endocrinologica
|November 1, 1989
PubMed
Summary
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Human immunodeficiency virus (HIV) infection can cause early dysregulation of the adrenocortical axis, with increased ACTH and cortisol levels in asymptomatic and lymphadenopathy stages. Adrenal insufficiency is a late complication in acquired immunodeficiency syndrome (AIDS).

Area of Science:

  • Endocrinology
  • Infectious Diseases
  • Immunology

Background:

  • Adrenal gland lesions are common in acquired immunodeficiency syndrome (AIDS) autopsies.
  • Glucocorticoid function in human immunodeficiency virus (HIV) infected individuals requires further investigation.
  • Understanding adrenocortical abnormalities across HIV infection stages is crucial.

Purpose of the Study:

  • To determine the incidence and nature of adrenocortical abnormalities in HIV-infected patients.
  • To assess glucocorticoid function at various stages of HIV infection.
  • To investigate potential mechanisms of adrenal dysregulation in HIV.

Main Methods:

  • Studied 63 HIV patients (Groups II, III, IV) and 30 controls.
  • Measured plasma ACTH and cortisol (basal and post-ACTH stimulation).

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  • Assessed plasma renin activity and aldosterone in a subset of patients.

    • Main Results:

    • Patients in CDC Groups II (asymptomatic) and III (lymphadenopathy) showed higher ACTH and basal cortisol levels than controls.
    • No significant differences in ACTH or cortisol levels were observed between Group IV (clinical manifestations) patients and controls.
    • Only one patient in Group IV exhibited a blunted cortisol response to ACTH stimulation.

    Conclusions:

    • Adrenal insufficiency is not frequent in advanced HIV (Group IV) and appears to be a late complication.
    • Early HIV infection (Groups II-III) is associated with increased ACTH and basal cortisol, suggesting early adrenocortical axis dysregulation.
    • Potential mechanisms for high ACTH in HIV include enhanced CRH production or direct effects of HIV gp120.