Adrenal function in HIV infection.
OBJECTIVE
Adrenal dysfunction can increase morbidity and mortality among patients with HIV infection. Disorders and medications affecting cortisol, aldosterone or adrenal androgens in patients with HIV infection are reviewed.


RESULTS
Iatrogenic Cushing's syndrome and hypothalamic-pituitary-adrenal suppression from concomitant use of ritonavir with nonsystemic corticosteroids such as intra-articular triamcinolone in addition to the previously reported interactions with inhaled fluticasone are increasingly recognized in HIV patients. Integrated measure of aldosterone throughout the day is higher in patients with HIV-associated visceral adipose tissue accumulation.


CONCLUSIONS
Abnormalities in adrenal function are more common in HIV patients than in the general population. HIV care providers should pursue workup for adrenal dysfunction in HIV patients when symptoms or signs are present, especially in patients with advanced AIDS or receiving medications that can affect adrenal function. The clinical implications of aldosterone elevation in HIV patients with visceral adiposity will need to be examined in future research studies.
Lo
Janet
J
Program in Nutritional Metabolism and Neuroendocrine Clinic, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
Grinspoon
Steven K
SK
D000311:Adrenal Glands / Q000503:physiopathology*; D000450:Aldosterone / Q000502:physiology; D005938:Glucocorticoids / Q000172:deficiency; D015658:HIV Infections / Q000503:physiopathology*; D006801:Humans; D006854:Hydrocortisone / Q000502:physiology; D008901:Mineralocorticoids / Q000172:deficiency
D005938:Glucocorticoids; D008901:Mineralocorticoids; D000450:Aldosterone; D006854:Hydrocortisone