title: Endocrine changes in male HIV patients.
abstract: OBJECTIVE
  To determine the frequency of adrenal, thyroid and gonadal dysfunction in HIV positive male patients and to evaluate the endocrine function at different level of CD4 cell counts.
  
  
  METHODS
  A total of 150 male HIV positive subjects were included in study. The patients were divided in three groups on the basis of CD4 cell counts. "Group A": HIV positive with CD4 count<200/mm "Group B": HIV positive with CD4 count 200-350/mm3 and "Group C": HIV positive with CD4 count>350/mm3.
  
  
  RESULTS
  In "group A" (n=50) 2 patients had basal cortisol<5 microg/dl while 23 patients had basal cortisol>25 microg/ dl. 15 patients had subclinical hypothyroidism while 11 patients had overt hypothyroidism. 25 patients in this group had gonadal dysfunction: majority of them (24) had primary gonadal dysfunction (elevated LH). None of the patients in "group B" (n=50) had hypocortisolism while 11 patients had elevated cortisol; 18 had subclinical hypothyroidism while 4 had overt hypothyroidism while 17 patients were hypogonad, all having elevated LH. In "group C" (n=50) 2 patients had hypocortisolism and 5 had elevated cortisol; 12 patients had subclinical and one had overt hypothyroidism; 7 patients had primary hypogonadism and one had secondary hypogonadism. Overall 4(2.66%) had hypocortisolism while 39 (26%) had elevated cortisol; 45 (30%) had subclinical hypothyroidism while 16(10.66%) had overt hypothyroidism. Gonadal dysfunction was observed in 50 patients (33%) majority of them (48) had primary hypogonadism. On analysis of Pearson's correlation coefficient CD4 count has strong inverse correlation with basal cortisol (r=-0.301, p<0.0001), TSH (r=-0.257, p=0.002) and LH (r=-0.228, p=0.006), while there was a direct correlation with serum testosterone (r=0.175, p=0.037).
  
  
  CONCLUSIONS
  This pilot study has demonstrated a high incidence of endocrine dysfunction in HIV infected patient in this part of country. High incidence of thyroid and gonadal dysfunction may contribute to morbidity of the patients and have a bearing on quality of life of the HIV infected patients. Hypocortisolism was not that common but high level of cortisol may be a marker of stress due to HIV per se or due to associated infection. Many of these dysfunctions might be transient and a large longitudinal study should be undertaken to substantiate the finding of the present study.
authors.affiliation: Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, UP.
authors.forename: L P
authors.initials: LP
authors.lastname: Meena
authors.forename: M
authors.initials: M
authors.lastname: Rai
authors.forename: S K
authors.initials: SK
authors.lastname: Singh
authors.forename: J
authors.initials: J
authors.lastname: Chakravarty
authors.forename: A
authors.initials: A
authors.lastname: Singh
authors.forename: R
authors.initials: R
authors.lastname: Goel
authors.forename: A
authors.initials: A
authors.lastname: Pathak
authors.forename: Shyam
authors.initials: S
authors.lastname: Sundar
mesh_terms: D000328:Adult; D000368:Aged; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D004702:Endocrine Glands / Q000503:physiopathology*; D004700:Endocrine System Diseases / Q000453:epidemiology / Q000209:etiology; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D013739:Testosterone / Q000097:blood*; D013963:Thyroid Hormones / Q000097:blood*; D055815:Young Adult
chemical_list: D013963:Thyroid Hormones; D013739:Testosterone; D006854:Hydrocortisone