title: Hypothalamic-pituitary-adrenal axis in HIV infection and disease.
abstract: HIV infection induces hypothalamic-pituitary-adrenal (HPA) axis derangements. Partial glucocorticoid resistance has been observed in a subset of AIDS patients, possibly owing to HIV-induced altered cytokine secretion and action. Because glucocorticoids have immunomodulatory effects, the severity of the HPA axis disorder could play a central role in disease progression. The characteristic phenotype of AIDS patients (visceral obesity, lipodystrophy) may be owing to effects of HIV proteins on the HPA axis, including changes in glucocorticoid and insulin sensitivity of target tissues, as well as altered cytokine production and interaction with the HPA axis, genetic causes, comorbidities, and, possibly, use of antiretroviral agents.
authors.affiliation: First Department of Pediatrics, "Agia Sofia" Children's Hospital, University of Athens, Thivon and Papadiamantopoulou, Athens 11527, Greece.
authors.forename: George P
authors.initials: GP
authors.lastname: Chrousos
authors.affiliation: First Endocrine Department and Diabetes Center, Alexandra Hospital, 80 Vassilisis Sofias Avenue, Athens 11528, Greece. Electronic address: liazapanti@yahoo.gr.
authors.forename: Evangelia D
authors.initials: ED
authors.lastname: Zapanti
mesh_terms: D000309:Adrenal Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D000818:Animals; D015658:HIV Infections / Q000150:complications* / Q000503:physiopathology*; D015497:HIV-1; D006801:Humans; D007027:Hypothalamic Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008661:Metabolism, Inborn Errors / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D011965:Receptors, Glucocorticoid / Q000172:deficiency
chemical_list: D011965:Receptors, Glucocorticoid
keywords: AIDS; Adrenals; Cortisol; HIV; HPA; Insulin resistance