Evidence of Endocrine Involvement Early in the Course of Human Immunodeficiency Virus Infection*

Abstract

Adrenal, gonadal, and thyroid function were assessed in 40 asymptomatic subjects in whom infection with the human immunodeficiency virus (HIV) had recently been documented. None of the patients had historical or clinical evidence of endocrine dysfunction. Their mean serum hormone levels were also within the expected ranges, but several differences were noted compared to those of seronegative controls. Basal cortisol, basal aldosterone, and ACTH-stimulated cortisol were significantly lower in the HIV group. One subject (2.5%) had a subnormal cortisol response, and two (5%) had abnormal aldosterone responses to ACTH. PRA tended to be higher, and serum angiotensin-converting enzyme levels somewhat lower in the HIV group. Serum free testosterone was markedly elevated in the HIV patients and was associated with an exaggerated LH response to GnRH, but PRL, estradiol, and basal and peak GnRH-stimulated FSH did not differ between groups. Three subjects (8%) had subclinical hypothyroidism. Serum thyroid hormone levels were normal, but basal T3 was lower in the HIV group compared to control values. While of little immediate clinical importance, many subtle endocrine aberrations are evident very early in the course of HIV infection. These findings obtained in HIV-seropositive subjects without infections or tumors and who were not receiving medical therapy suggest an effect of HIV on each of the endocrine systems examined.

Association between antiretrovirals and thyroid diseases: a cross-sectional study

“…During disease recovery, TSH levels may increase temporarily, sometimes exceeding the normal range, thus returning FT 4 and T 3 levels to normal values, mimicking subclinical hypothyroidism. Among the HIV--infected population, the highest frequency of thyroid disease was reported in patients with terminal AIDS before HAART, with up to 16% of patients affected (30). In this study, TSH and FT 4 levels were obtained in low levels in only one patient (0.85%).…”

“…Therefore, the clinical significance of a low FT 4 levels is not clear because these patients did not experience a higher frequency of hypothyroidism symptoms compared with control subjects. Thyroid function tests may be requested annually, but levothyroxine therapy is not recommended (30).…”

Cortisol Response Mediates HIV-1-Related Cognitive Deficits Among Injecting Drug Abusers

“…Several studies have reported the occurrence of endocrine dysfunctions in HIV-1 infection [8][9][10][11][12] . ACTH and cortisol are important markers of neuroendocrine responses to different physical and psychological stressors.…”

“…In addition, the attenuated autonomic response observed in HIV-1 infection [13] may be another route that affects the HPA axis, since integration of the central autonomic system with the CNS is essential for the activation of the HPA axis [14] . However, the kinetics of the cortisol response, rather than absolute concentrations of cortisol, are considered to be more important in the neurohormonal response to stress and successful adaptation to stressors [11] . In order to investigate the cortisol response, even though there are a number of behavioral and laboratory paradigms, this investigation used the cold pressor challenge since possible cognitive complications occurring in HIV-1 infection may confound the results of behavioral challenges involving speech or arithmetic paradigms.…”

To Study the Prevalence of Thyroid Dysfunction in Newly Diagnosed HIV +ve Patients and Correlation between CD4 Count and Thyroid Dysfunction

“…and direct infection of the gland by HIV. [5,6] However, there is insufficient evidence to recommend routine thyroid screening of asymptomatic HIV-infected individuals. Hence this study was undertaken, to evaluate the prevalence of thyroid abnormalities in this subset of newly diagnosed HIV positive patients.…”