title: A preliminary report on basal & stimulated plasma cortisol in patients with acquired immunodeficiency syndrome.
abstract: OBJECTIVE
  Structural and/or functional alterations in adrenal glands have been reported in human immunodeficiency virus (HIV) infection. However, no information has been reported from India. Hence a study was undertaken to assess the basal and circadian variations in plasma cortisol, and cortisol response to bolus ACTH in patients with AIDS.
  
  
  METHODS
  Basal and stimulated plasma cortisol levels at 0800 h and 1600 h and, at 30 and 60 min following an intravenous bolus of 250 micrograms ACTH (short synacthen test, SST) were estimated in 15 patients with AIDS (CD4 < or = 200/microliter) and 12 healthy controls. The nature of the opportunistic infections and/or associated disease in each patient was also studied.
  
  
  RESULTS
  The patients had higher median basal plasma cortisol levels as compared to the controls at 0800 h (540 nmol/l vs 415 nmol/l, P < 0.005) and at 1600 h (420 nmol/l vs 285 nmol/l, P < 0.003). Five patients (33%) exhibited abnormal circadian cortisol rhythms. All subjects in the control group and all but one (6.6%) in the patients group had normal peak plasma cortisol response (> or = 550 nmol/l) to SST. The lone patient with subnormal cortisol response had no feature of adrenal insufficiency. On the contrary, 3 patients clinically suspected to have adrenal insufficiency, had normal plasma cortisol response.
  
  
  CONCLUSIONS
  These findings suggest that most patients with AIDS have elevated basal plasma cortisol levels with abnormal circadian rhythm in some and normal adrenocortical reserve irrespective of the symptoms/signs of adrenal insufficiency.
authors.affiliation: Department of Endocrinology, Postgraduate Institute of Medical Education & Research, Chandigarh.
authors.forename: A
authors.initials: A
authors.lastname: Bhansali
authors.forename: R J
authors.initials: RJ
authors.lastname: Dash
authors.forename: A
authors.initials: A
authors.lastname: Sud
authors.forename: S
authors.initials: S
authors.lastname: Bhadada
authors.forename: S
authors.initials: S
authors.lastname: Sehgal
authors.forename: B R
authors.initials: BR
authors.lastname: Sharma
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000097:blood* / Q000503:physiopathology; D000293:Adolescent; D000302:Adrenal Cortex / Q000503:physiopathology; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged
chemical_list: D006854:Hydrocortisone