Department of Internal Medicine, Faculty of Health Sciences, Walter Sisulu University, Mthatha, South Africa.
Med Princ Pract. 2011;20(6):525-9. doi: 10.1159/000330022. Epub 2011 Oct 4.
To determine the frequency of occurrence of hypoadrenalism in patients with human immunodeficiency virus (HIV) infection and document the clinical correlates of hypoadrenalism for this group of patients.
A descriptive study was carried out on 66 hospitalized HIV patients in a semi-urban setting of South Africa. Hypoadrenalism was diagnosed based on a basal cortisol level of less than 400 nmol/l with or without overt signs and symptoms. Clinical and biochemical parameters of hypoadrenalism were compared between subjects with suboptimal and normal cortisol levels. Statistical analysis included Student's t test, χ(2) and Pearson's correlation coefficient tests.
The prevalence of hypoadrenalism was 27% with a high occurrence of contributory factors (cytomegalovirus infection in 100% and tuberculosis in 68.2% of the study subjects). Typical features of hypoadrenalism included: hyponatremia, 19.6%; hyperkalemia, 6.1%; mucosal hyperpigmentation, 12%, and loss of axillary hair, 15%. Comparison of clinical and biochemical parameters of hypoadrenalism did not show a correlation between CD4 count and cortisol levels (r = 0.1 and p = 0.3).
The prevalence of hypoadrenalism in our patients with HIV infection was high and the clinical features were comparable in subjects with normal and subnormal cortisol levels.
确定人类免疫缺陷病毒 (HIV) 感染患者发生肾上腺功能减退的频率，并记录该组患者肾上腺功能减退的临床相关因素。
在南非半城市环境中对 66 例住院 HIV 患者进行描述性研究。根据基础皮质醇水平低于 400nmol/L 伴或不伴明显体征和症状诊断为肾上腺功能减退。比较皮质醇水平欠佳和正常的患者的肾上腺功能减退的临床和生化参数。统计分析包括学生 t 检验、卡方检验和 Pearson 相关系数检验。
肾上腺功能减退的患病率为 27%，有较高的促成因素发生率（巨细胞病毒感染占 100%，研究对象中结核病占 68.2%）。肾上腺功能减退的典型特征包括：低钠血症，19.6%；高钾血症，6.1%；黏膜色素沉着，12%，腋毛脱落，15%。肾上腺功能减退的临床和生化参数比较显示，CD4 计数与皮质醇水平之间无相关性（r = 0.1，p = 0.3）。
我们的 HIV 感染患者肾上腺功能减退的患病率较高，皮质醇水平正常和欠佳的患者的临床特征相似。
