FREQUENCY OF ADRENAL INSUFFICIENCY AMONG PATIENTS OF HUMAN IMMUNODEFICIENCY VIRUS

Abstract

Background: Human immunodeficiency virus (HIV) has emerged as a major public health problem worldwide over the last two decades. Many complications and problems are associated with HIV like lipodystrophy, retarded growth in young patients, impaired endocrine and renal functioning and cardiovascular diseases.

Objective: To determine the frequency of adrenal insufficiency among patients of human immunodeficiency virus presenting to HIV clinic in a tertiary care hospital.

Study Design: Cross Sectional Study.

Setting: HIV clinic, Jinnah Hospital Lahore.

Study Duration: August, 2019 to February, 2020.

Material and Methods: A total of 180 patients of HIV presenting to HIV clinic of Jinnah hospital Lahore and fulfilling the selection criteria were approached after approval from ethical review board an informed consent was taken from the subject and an ACTH stimulation test was performed and adrenal Insufficiency was diagnosed. Intramuscular injection of 0.25 mg of synthetic ACTH was administered to all patients; and after 60 minutes serum cortisol was measured. A peak stimulated cortisol of less than 20 mcg/dl was labeled as adrenal insufficiency.

Results: Mean and standard deviation of the age was 42.16 ± 17.31 years. Male patients were 56.1% while female patients were 43.9%.  Adrenal insufficiency was present in 38.3% patients while it was absent in 61.7% patients. No significant association found between age and presence of adrenal insufficiency (p=0.280). Also no significant association found between duration of disease and adrenal insufficiency (p=.557). There was a significant association found between intake of antiretroviral therapy and presence of adrenal insufficiency having (p<0.005)

Conclusion: Adrenal insufficiency was found in significant number of HIV patients but effect modifiers like age, duration of disease did not show significant association except intake of antiretroviral therapy.