Correlation of baseline hormonal disorders with immunological failure and mortality in male HIV patients during follow-up

Abstract

To assess the effect that hormonal disturbances have on HIV prognosis in male patients. A prospective follow-up study was conducted among male HIV patients who started antiretroviral therapy (ART) between July 1, 2011 and June 30, 2014. The final follow-up session occurred before December 31, 2014. We examined the correlation between pre-ART hormone levels and disease prognosis. The Kaplan–Meier method and the multivariate Cox proportional hazard model were used to identify hormone-related predictors of immunological failure and mortality. During the follow-up of 163 male HIV patients, mortality rate occurred at a rate of 16.0% (26/163). Of these deaths, 84.6% (22/26) were acquired immunodeficiency syndrome–related. Furthermore, 53 patients were found to have suffered from immunological failure. Both pre-ART CD4+ T cell counts and the clinical stage assigned to the patients correlated strongly with dehydroepiandrosterone sulfate levels. Hyponatremia, high cortisol levels, tuberculosis, and being at World Health Organization (WHO)-defined clinical stage 4 were characteristics that associated significantly with mortality. Being at WHO clinical stage 4 was, itself, a factor that significantly associated with immunological failure. High cortisol levels were found to be an important hormonal disorder that associated with mortality. None of the hormones examined in this study had a strong correlation with immunological failure.

Endocrinopathies in Hiv Infected Patients

“…Cytokines, such as interleukin-1 (IL-1) and interferon alpha (IFNα), acting indirectly or directly, could well modulate adrenal steroid production via their influence on the hypothalamic-pituitary-adrenal (HPA) axis. However our findings, which demonstrated no correlation between CD4 count and cortisol, differed from previous studies, possibly due to our smaller sample size [9]. There were no significant correlations between CD4 count and levels of gonadal hormones.…”

Hyponatremia in Infectious Diseases—A Literature Review

“…Despite the fact that SIADH is considered to be one of the factors leading to hyponatremia in HIV-infections or AIDS, no differences between the ADH, renin, or aldosterone levels of HIV patients and those of non-HIV-infected subjects were observed [ 30 ]. Currently, there is no strong data that would support the thesis that hyponatremia may contribute directly to increased mortality among HIV-infected patients.…”