Dysfunction of the hypothalamic-pituitary-adrenal axis in HIV infection and disease.
Abnormalities of the hypothalamic-pituitary-adrenal (HPA) axis have been documented in HIV patients in the early as well as late stages of the infection and range from subtle subclinical disturbances to frank adrenal insufficiency. Potential etiologies of these disorders include opportunistic infections, neoplasms, drugs administered to treat infections, cytokine abnormalities associated with the HIV disease process and acquired alterations in tissue sensitivity to glucocorticoids. In this article, we present a concise review of HPA abnormalities in HIV infection and disease with regard to their etiology with emphasis on syndromes of hypersensitivity/resistance to glucocorticoids associated with antiviral medications and/or the HIV infection itself.
Zapanti
Evangelia
E
1st Department of Endocrinology, Alexandra Hospital, Athens, Greece. liazapanti@yahoo.gr
Terzidis
Konstantinos
K
Chrousos
George
G
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000307:Adrenal Gland Diseases / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D000309:Adrenal Insufficiency / Q000209:etiology / Q000503:physiopathology; D019380:Anti-HIV Agents / Q000009:adverse effects; D003480:Cushing Syndrome / Q000209:etiology / Q000503:physiopathology; D004351:Drug Resistance; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology / Q000821:virology; D015497:HIV-1 / Q000472:pathogenicity*; D039682:HIV-Associated Lipodystrophy Syndrome / Q000503:physiopathology / Q000821:virology; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects / Q000503:physiopathology* / Q000821:virology; D007333:Insulin Resistance; D010913:Pituitary-Adrenal System / Q000187:drug effects / Q000503:physiopathology* / Q000821:virology
D000305:Adrenal Cortex Hormones; D019380:Anti-HIV Agents