Chapter 37. Endocrine Disorders in HIV/AIDS (original) (raw)

GENERAL PRINCIPLES • Acquired immunodeficiency syndrome (AIDS) is caused by the human immunodeficiency virus (HIV), which is transmitted by exchange of infected blood, semen, or vaginal secretions through mucosal membranes. HIV targets CD4+ T lymphocytes, where it integrates into the host DNA, replicates, and produces new virions that infect and reduce T-cell number. This weakens host immunity and renders the host susceptible to common pathogens [1]. • Currently, there is no vaccine or cure for HIV. However, since the mid-1990s the use of highly active antiretroviral therapy (HAART) has reduced HIV-related morbidity and mortality so effectively that HIV infection is now considered a chronic manageable infection [1]. • HIV infection and HAART are associated with several endocrine, metabolic, anthropomorphic, and cardiovascular complications. • All patients with HIV infection are at risk for endocrine disorders. Reasons include: increased inflammation (HIV replication, obesity), AIDS wasting, presence of opportunistic infections, HAART toxicities, immune reconstitution syndrome, genetic risk and traditional environmental factors [2]. • In general, the signs and symptoms of endocrine disorders in patients with HIV infection do not differ from those observed in immunocompetent individuals. Please refer to the previous chapters for specific examples of presentations for each given disorder.