Adrenal Insufficiency: A Forgotten Diagnosis in HIV/AIDS Patients in Developing Countries.

Journal: International journal of endocrinology

Volume: 2019

Issue: 

Year of Publication: 

Affiliated Institutions:  Department of Internal Medicine, Mbeya Zonal Referral Hospital, Mbeya, Tanzania. Department of Microbiology and Immunology, School of Medicine & Dentistry, College of Health Sciences, The University of Dodoma, Dodoma, Tanzania. National Institute for Medical Research, Mbeya Medical Research Center, Mbeya, Tanzania. Department of Internal Medicine, School of Medicine & Dentistry, College of Health Sciences, The University of Dodoma, Dodoma, Tanzania. Department of Psychiatry and Mental Health, University of Dar es Salaam, Mbeya College of Health and Allied Sciences, Mbeya, Tanzania.

Abstract summary 

Adrenal insufficiency (AI) is one of the most common endocrine disease in patients with HIV/AIDS, leading to high morbidity and mortality in HIV patients who become critically ill. Various etiologies are associated with the condition, including cytomegalovirus (CMV), , lymphoma, Kaposi's sarcoma, and drugs such as rifampin, among others. HIV patients with advanced disease develop relative cortisol deficiency largely due to the reduction of cortisol reserve, which predisposes patients to adrenal crisis in periods of stress or critical illness. The prevalence of AI in HIV/AIDS patients during HAART era is higher in developing than developed countries, probably due to limited access to both diagnosis and adequate treatments which increases the risk of opportunistic infections. The clinical features of functional adrenal insufficiency in HIV/AIDS patients can be masked by various infectious, noninfectious, and iatrogenic causes, which reduce clinical recognition of the condition. Development of simple screening algorithms may help clinicians reach the diagnosis when approaching these patients. In many low-income countries, most HIV patients are diagnosed with advanced disease; thus, further research is necessary to elucidate the prevalence of adrenal insufficiency in HIV/AIDS patients and the condition's impact on mortality in this population.

Authors & Co-authors:  Nassoro David D DD Mkhoi Mkhoi L ML Sabi Issa I Meremo Alfred J AJ Lawala Paul S PS Mwakyula Issakwisa Habakkuk IH

Study Outcome 

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Statistics
Citations :  Meya D. B., Katabira E., Otim M., et al. Functional adrenal insufficiency among critically ill patients with human immunodeficiency virus in a resource-limited setting. African Health Sciences. 2007;7(2)
Authors :  6
Identifiers
Doi : 2342857
SSN : 1687-8337
Study Population
Male,Female
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Other Terms
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Study Approach
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Publication Country
Egypt