Longitudinal study of adrenal steroids in a cohort of HIV-infected patients with hemophilia.
The objective of the study was to relate plasma dehydroepiandrosterone sulfate (DHEA-S) concentrations to the progression of HIV infection in individual HIV-infected men with hemophilia and to obtain information on the cause of DH EA-S alterations. Blood samples were obtained from 16 men with hemophilia; in 9 men serial samples were available for up to 11 years after HIV-1 infection. Control samples were obtained from men of comparable ages without hemophilia or HIV infection. Measurements were made of CD4+ cell counts, plasma adrenocorticotropic hormone (ACTH), cortisol, DHEA, DHEA-S, and prolactin. Before HIV infection, men with hemophilia had significantly lower plasma levels of DHEA-S than control men. After infection, 3 of 9 subjects studied serially had little or no change in plasma DHEA-S levels or in CD4+ cell counts over 11 years. Four of the 9 i n whom AIDS developed had progressive decreases in plasma DHEA-S concentrations that, in some cases, preceded a precipitous fall in CD4+ cell counts. Major decreases in plasma DHEA-S levels before falls in CD4+ counts were observed in 2 ot her subjects who had other severe illnesses. None of the decreases in DHEA-S levels were associated with decreased concentrations of plasma cortisol, ACTH, or prolactin. We conclude that plasma DHEA-S is an indicator of general health rather than a specific indicator for progression of HIV. The decrease in plasma DHEA-S is not related to ACTH stimulation of the adrenal gland or to cortisol secretion, but it may be related to cytokines that can inhibit 17-hydroxylation of DH EA-S precursors.
Chatterton
R T
RT
Department of Obstetrics and Gynecology, Northwestern University Medical School, Chicago, IL 60611, USA.
Green
D
D
Harris
S
S
Grossman
A
A
Hechter
O
O
D000163:Acquired Immunodeficiency Syndrome / Q000097:blood* / Q000150:complications; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D003687:Dehydroepiandrosterone / Q000031:analogs & derivatives* / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D006854:Hydrocortisone / Q000145:classification; D008137:Longitudinal Studies; D008297:Male; D011388:Prolactin / Q000097:blood
D003687:Dehydroepiandrosterone; D019314:Dehydroepiandrosterone Sulfate; D000324:Adrenocorticotropic Hormone; D011388:Prolactin; D006854:Hydrocortisone