Endocrine Disorders in Brazilian Patients with Acquired Immune Deficiency Syndrome

Abstract

Acquired immunodeficiency syndrome (AIDS) was first reported in Brazil in 1980. In 1997, its incidence was 147 per million and then declined to 90 per million in 2000. Abnormalities of endocrine organ systems occur frequently in patients with AIDS. We evaluated mineralcorticoid, glucocorticoid, and thyroid hormone axes and glucose and insulin responses to a standardized oral glucose dose in healthy individuals; human immunodeficiency virus (HIV)-seropositive, asymptomatic individuals; HIV-infected patients with general lymphadenopathy, diarrhea, fever, fatigue, nocturnal sweating, and weight loss; and HIV-infected patients diagnosed with secondary infectious diseases or neoplasms. Baseline cortisol levels in the patients with AIDS were significantly higher than those in healthy control subjects. However, after adrenocorticotrophic hormone stimulation, cortisol levels were significantly lower in HIV-infected patients. Insulin concentrations were significantly higher after the glucose load in HIV-infected asymptomatic than in patients with AIDS. There were no significant differences in mineralocorticoid or thyroid function among groups.

Subclinical Hypothyroidism in HIV-Infected Patients Is Not an Autoimmune Disease

“…Although SCH has been reported early in the course of HIV infection and before the HAART era [20], drug-related adverse effects must be considered. Indeed, it has been reported that treatment-naïve, non-immunocompromised, infected patients have normal thyroid function [21] and the majority of studies describing hypothyroidism in HIV-infected patients were in patients receiving HAART [2,3,4]. In our study, use of stavudine was associated with the SCH subgroup, stavudine, didanosine and ritonavir with the LT4 subgroup.…”

Assessment of the Factors Involving in the Development of Hypothyroidism in HIV-infected Patients: A Case-Control Study

“…Treatment of HIV infected patients with highly active antiretroviral drugs (HAART), especially with stavudine [1,8,9,11], increase in total cholesterol serum levels after HAART initiation [2], and history of opportunistic infections [3] is among contributors of subclinical hypothyroidism. Drugs like rifampin, Kaposi's sarcoma, and mycobacterial infections may additionally impair thyroid function [10,[12][13][14][15][16][17][18].…”

Interventions for Metabolic and Endocrine Complications of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome and Illicit Drug Use

“…Rosita Fontes (Catholic University, Rio de Janeiro) (see the article by Fontes et al [21] in this supplement) also showed that HIV infection was associated with abnormal adrenal, thyroid, and pancreatic function in a Brazilian cohort of patients with significantly higher cortisol levels, an increased incidence of hypoglycemia of multifactorial cause, and lower levels of insulin. In contrast, Grinspoon [12] reported higher levels of insulin.…”