CD4 count as a predictor of adrenocortical insufficiency in persons with human immunodeficiency virus infection: How useful?
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Date
2013-11
Authors
Odeniyi, I.
Fasanmade, O.
Ajala, M.O.
Ohwovoriole, A.
Journal Title
Journal ISSN
Volume Title
Publisher
Medknow publications
Abstract
OBJECTIVE: To determine the usefulness of CD4 count in predicting adrenocortical insufficiency (AI) in persons with HIV infection.
DESIGN:
Experimental study involving people with HIV infection and healthy people.
PARTICIPANTS:
The participants were recruited from the Lagos University Teaching Hospital. Forty-three newly diagnosed, treatment naive persons with HIV (23 males and 20 females) and 70 (35 males and 35 females) HIV negative subjects completed the study.
INTERVENTION:
One microgram Synacthen(®) was given intravenously to stimulate the adrenal glands.
MAIN OUTCOME MEASURES:
Blood was collected for cortisol at 0 and 30 min after the injection of adrenocorticotropic hormone (ACTH) and CD4 count.
RESULTS:
Mean basal cortisol was 154.9 ± 27.2 nmol/L and 239.9 ± 31.6 nmol/L (P < 0.001); the 30-min post ACTH test, cortisol level was 354.8 ± 19.9 nmol/L and 870.9 ± 163.5 nmol/L (P < 0.001); the increment was 100.0 ± 17.2 nmol/L and 588.8 ± 143.4 nmol/L (P < 0.001) in HIV and healthy subject group; respectively. Using the diagnostic criteria for diagnosis of AI in this study, fifteen (34.8%) persons with HIV had AI. There was no significant correlation between basal cortisol levels and CD4 count in patients with HIV infection (r = -0.2, P = 0.198). There was no significant correlation between stimulated cortisol level and CD4 count in patients with HIV infection (r = -0.09, P = 0.516).
CONCLUSION:
CD4 count does not predict the presence or absence of AI. ACTH stimulation of the adrenal gland remains the acceptable standard.
Description
Staff publications
Keywords
adrenocorticotropic hormone (ACTH) , CD4 count , Cortisol , Human immunodeficiency virus , Research Subject Categories::MEDICINE
Citation
Odeniyi IA, Fasanmade OA, Ajala MO, Ohwovoriole AE. CD4 count as a predictor of adrenocortical insufficiency in persons with human immunodeficiency virus infection: How useful? Indian J Endocrinol Metab. 2013 Nov;17(6):1012-7. doi: 10.4103/2230-8210.122615