HIV infection, as well as its treatment with highly active retroviral therapy (HAART), is associated with a number of metabolic abnormalities such as insulin resistance, glucose intolerance and dyslipidaemia. The aim of this descriptive cross sectional study was to describe the prevalence of diabetes, impaired fasting glucose, dyslipidaemia and obesity among patients with HIV or AIDS who were followed up at the National Sexually Transmitted Diseases (STD) campaign in the year 2010, and to assess the associated factors.A total of 268 patients were evaluated of which 57.8% were male. Fifty six percent were on HAART therapy. Eighteen patients (6.7%) were diabetics and forty nine (18.3%) had impaired fasting glucose. Only about 40% of the diabetic patients were followed up regularly. About 20% of the patients had high total cholesterol levels (>240mg/dl) and only 24.4% patients had an optimal LDL cholesterol level of <100 mg/dl. 15.3% of the patients had high serum triglyceride levels (200-499mg/dl) and 1.9% had very high triglyceride levels (>500 mg/dl). Fourteen percent of the patients were overweight and 18.2% of the patients were obese according to the WHO criteria for body mass index for Asians. Being on HAART therapy was significantly associated with having high total cholesterol levels, high LDL cholesterol levels and high triglyceride cholesterol levels but not with elevated blood glucose values in the X 2 test (p<0.05). The mean total cholesterol, LDL cholesterol and triglyceride levels were also significantly different among HAART users and non users. Having HIV for more than 3.1 years (more than the median) and duration of HAART therapy for more than 1.9 years (more than the median) were also significantly associated with high total cholesterol and LDL cholesterol levels (p<0.05).Metabolic abnormalities are common among HIV infected persons and some of them are associated with the duration of HIV and the use of HAART therapy.

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The diagnosis of Cushing's syndrome as well as delineating its aetiology can be often challenging, especially in the mild cases with atypical features. Although the combined clinical features such as the age, gender and the severity of the hypercortisolism can usually help to differentiate between pituitary ACTH hyper secretion from an ectopic ACTH source, this may sometimes be inaccurate. The presence of caveats in most biochemical testing and imaging modalities as well as the relative unavailability of certain dynamic tests and catheter based studies can contribute to the dilemma.