What is the rate and mechanism of development of adrenal insufficiency in AIDS patients?

Endocrinology of HIV/AIDS.  In:  Williams Textbook of Endocrinology, 12th ed.
Cites study of 74 hospitalized AIDS patients that reported 17% of patients had cortisol level at 1 hour <18 microg/dL.  However, only 4% of patients demonstrated clinical symptoms of adrenal insufficiency.  This chapter also reviews factors associated with development of renal insufficiency, including tissue destruction of the adrenal glands from opportunistic infections and reduced aldosterone and dehydroepiandrosterone responses to adrenocorticotropic hormone.

Another study (Crit Care Med  2002; 30:1267-1273) of 28 critically ill hiv-positive patients reported rate of adrenal insufficiency to be 7-75% depending on criteria used.


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