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

Medicine (Baltimore). 2016 Dec;95(52):e5732. doi: 10.1097/MD.0000000000005732.

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.

MeSH terms

  • Adrenocorticotropic Hormone / blood
  • Adult
  • Aldosterone / blood
  • Anti-HIV Agents / therapeutic use
  • CD4 Lymphocyte Count
  • Dehydroepiandrosterone Sulfate / blood
  • Follow-Up Studies
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Infections / immunology
  • HIV Infections / mortality
  • Humans
  • Hydrocortisone / blood
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Treatment Failure
  • Young Adult

Substances

  • Anti-HIV Agents
  • Natriuretic Peptide, Brain
  • Aldosterone
  • Dehydroepiandrosterone Sulfate
  • Adrenocorticotropic Hormone
  • Hydrocortisone