Assessment of adrenal cortex function in a group of HIV infected patients in sub-Saharan-Africa

The relationship between adrenal insufficiency and the HIV infection have been less investigated. The aim of this study was to assess the adrenal cortex function according to the stage of infection in a group of HIV-infected patients in sub-Saharan Africa. We conducted a cross-sectional study in 60 consenting subjects consisted of 20 healthy controls and 40 HIV-infected patients divided equally into 4 groups according to the stage of the infection. Plasma cortisol levels were measured at baseline and after synacthen stimulation by ELISA test. Basal and post-synacthen cortisol levels were comparable between healthy controls and HIV infected patients. Overall, the majority of HIV-infected subjects and healthy controls had normal cortisol levels at baseline. Only 5% of the HIV-infected patients in stage 4 had absolute adrenal insufficiency. The majority of HIV-infected subjects and healthy controls doubled their cortisol levels after synacthen stimulation. They were considered as having normal adrenal function. Adrenal function seems to be preserved in the majority of HIV-infected patients. However, patients at the late stage of the disease could have an impairment of adrenal function and therefore should be placed on cortisol supplementation.