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Adrenal disorders in human immunodeficiency virus (HIV) infected patients.
[adrenal incidentaloma]
Human
Immunodeficiency
Virus
(
HIV
)
infection
is
associated
with
adrenal
disorders
,
which
must
not
be
underestimated
.
Adrenal
morphologic
changes
are
primarily
related
to
opportunistic
infections
,
mostly
by
cytomegalovirus
and
mycobacteria
,
and
malignant
tumours
such
as
non-
Hodgkin
's
lymphoma
and
Kaposi
's
sarcoma
.
The
most
frequent
biological
alteration
reported
to
date
is
the
increases
in
cortisol
concentrations
which
results
from
a
decrease
in
cortisol
metabolism
and
hyperactivity
of
the
hypothalamo-
pituitary
-
adrenal
axis
commonly
referred
to
as
pseudo-
Cushing
's
syndrome
.
These
modifications
can
be
a
consequence
of
antiretroviral
therapy
and
do
not
require
any
investigation
or
specific
treatment
.
Conversely
,
adrenal
insufficiency
,
either
iatrogenic
or
secondary
to
glandular
infiltration
by
neoplasms
or
infections
,
needs
long
-term
substitution
with
hydrocortisone
,
but
at
present
occurs
more
rarely
and
usually
at
late
stages
of
disease
progression
.
The
impact
of
HIV
infection
on
the
other
adrenocortical
functions
has
been
less
reported
in
the
literature
although
several
studies
show
low
levels
of
adrenal
androgens
,
especially
dehydroepiandrostenedione
(
DHEA
)
.
Impairment
in
mineralocorticoid
function
appears
occasional
and
remains
a
subject
of
debate
.
Diseases
Validation
Diseases presenting
"either iatrogenic or secondary to glandular infiltration by neoplasms or infections"
symptom
adrenal incidentaloma
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