title: Basal cortisol levels and correlates of hypoadrenalism in patients with human immunodeficiency virus infection.
abstract: OBJECTIVE
  To determine the frequency of occurrence of hypoadrenalism in patients with human immunodeficiency virus (HIV) infection and document the clinical correlates of hypoadrenalism for this group of patients.
  
  
  METHODS
  A descriptive study was carried out on 66 hospitalized HIV patients in a semi-urban setting of South Africa. Hypoadrenalism was diagnosed based on a basal cortisol level of less than 400 nmol/l with or without overt signs and symptoms. Clinical and biochemical parameters of hypoadrenalism were compared between subjects with suboptimal and normal cortisol levels. Statistical analysis included Student's t test, χ(2) and Pearson's correlation coefficient tests.
  
  
  RESULTS
  The prevalence of hypoadrenalism was 27% with a high occurrence of contributory factors (cytomegalovirus infection in 100% and tuberculosis in 68.2% of the study subjects). Typical features of hypoadrenalism included: hyponatremia, 19.6%; hyperkalemia, 6.1%; mucosal hyperpigmentation, 12%, and loss of axillary hair, 15%. Comparison of clinical and biochemical parameters of hypoadrenalism did not show a correlation between CD4 count and cortisol levels (r = 0.1 and p = 0.3).
  
  
  CONCLUSIONS
  The prevalence of hypoadrenalism in our patients with HIV infection was high and the clinical features were comparable in subjects with normal and subnormal cortisol levels.
authors: Department of Internal Medicine, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa.
authors: Chukwuma O
authors: CO
authors: Ekpebegh
authors: Anthonia O
authors: AO
authors: Ogbera
authors: Benjamin
authors: B
authors: Longo-Mbenza
authors: Ernesto
authors: E
authors: Blanco-Blanco
authors: Ajani
authors: A
authors: Awotedu
authors: Patrick
authors: P
authors: Oluboyo
mesh_terms: D000293:Adolescent; D000309:Adrenal Insufficiency / Q000097:blood / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D003586:Cytomegalovirus Infections / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D013019:South Africa / Q000453:epidemiology; D013223:Statistics as Topic; D055815:Young Adult
chemical_list: D006854:Hydrocortisone