Endocrine and metabolic disorders associated with human immune deficiency virus infection.
BACKGROUND
Many reports have described endocrine and metabolic disorders in the human immunodeficiency virus (HIV) infection. This article reviewed various reports in the literature in order to increase the awareness and thus the need for early intervention when necessary.


METHODS
Data were obtained from MEDLINE, Google search and otherjournals on 'HIV, Endocrinopathies/Metabolic Disorders' from 1985 till 2007.


METHODS
Studies related to HIV associated endocrinopathies and metabolic disorders in the last two decades were reviewed.


METHODS
Information on epidemiology, pathogenesis, diagnosis and treatment of the target organ endocrinopathies and metabolic disorders in HIV/AIDS were extracted from relevant literature.


RESULTS
Endocrine and metabolic disturbances occur in the course of HIV infection. Pathogenesis includes direct infection of endocrine glands by HIV or opportunistic organisms, infiltration by neoplasms and side effects of drugs. Adrenal insufficiency is the commonest HIV endocrinopathy with cytomegalovirus adrenalitis occurring in 40-88% of cases. Thyroid dysfunction may occur as euthyroid sick syndrome or sub-clinical hypothyroidism. Hypogonadotrophic dysfunction accounts for 75% of HIV-associated hypogonadism, with prolonged amenorrhoea being three times more likely in the women. Pancreatic dysfunction may result in hypoglycaemia or diabetes mellitus (DM). Highly active antiretroviral therapy (HAART) especially protease inhibitors has been noted to result in insulin resistance and lipodystrophy.


CONCLUSIONS
Virtually every endocrine organ is involved in the course of HIV infection. Detailed endocrinological and metabolic evaluation and appropriate treatment is necessary in the optimal management of patients with HIV infection in our environment.
Unachukwu
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CN
Department of Medicine, University of Port Harcourt Teaching Hospital, Rivers State, Nigeria. chiomaunachukwu@yahoo.com
Uchenna
D I
DI
Young
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EE
D019380:Anti-HIV Agents / Q000009:adverse effects; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D004700:Endocrine System Diseases / Q000453:epidemiology / Q000209:etiology*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008659:Metabolic Diseases / Q000453:epidemiology / Q000209:etiology*; D009549:Nigeria / Q000453:epidemiology; D012307:Risk Factors
D019380:Anti-HIV Agents