title: Glucocorticoid level and neuropsychiatric symptoms in homosexual men with HIV infection.
abstract: OBJECTIVE
  There is a controversial literature suggesting that stress, anxiety, and depression are harmful to the immune system and therefore to health. Preclinical studies indicate that activation of the hypothalamic-pituitary-adrenal (HPA) axis by stress may be responsible for immunocompromise. The goal of this study was to assess this phenomenon in human immunodeficiency virus (HIV) infection.
  
  
  METHODS
  Homosexual men in the community who did not meet modified Centers for Disease Control criteria for acquired immune deficiency syndrome (AIDS) were recruited for the study; 113 of the men were HIV positive and 77 were HIV negative. Very few of the men studied suffered from depression or anxiety disorder at the time of the first assessment. Twenty-four-hour urinary free cortisol levels were obtained from the 112 HIV-positive and 75 HIV-negative men whose 24-hour urine volumes were 500 ml or more. Cortisol levels were correlated with measures of medical, immunological, neurological, and psychiatric status.
  
  
  RESULTS
  Small but significant correlations between 24-hour urinary free cortisol and medical status, level of depression, and level of anxiety were found in the HIV-positive group. There was no relationship between cortisol level and the number of CD4+ or CD8+ T lymphocytes or the CD4-CD8 ratio.
  
  
  CONCLUSIONS
  Although HPA activation may be associated with stress in cases of HIV infection, it does not seem to be associated with further loss of CD4+ T lymphocytes. Subjects with HIV infection with the most evidence of medical complications may also be the most anxious and depressed.
authors.affiliation: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, NY.
authors.forename: J M
authors.initials: JM
authors.lastname: Gorman
authors.forename: R
authors.initials: R
authors.lastname: Kertzner
authors.forename: T
authors.initials: T
authors.lastname: Cooper
authors.forename: R R
authors.initials: RR
authors.lastname: Goetz
authors.forename: I
authors.initials: I
authors.lastname: Lagomasino
authors.forename: H
authors.initials: H
authors.lastname: Novacenko
authors.forename: J B
authors.initials: JB
authors.lastname: Williams
authors.forename: Y
authors.initials: Y
authors.lastname: Stern
authors.forename: R
authors.initials: R
authors.lastname: Mayeux
authors.forename: A A
authors.initials: AA
authors.lastname: Ehrhardt
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D003866:Depressive Disorder / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D006679:HIV Seropositivity / Q000150:complications / Q000175:diagnosis / Q000276:immunology; D006716:Homosexuality; D006801:Humans; D006854:Hydrocortisone / Q000652:urine*; D007165:Immunosuppression Therapy; D007958:Leukocyte Count; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology
chemical_list: D006854:Hydrocortisone