Katherine Samaras1,2,3
- St Vincent’s Clinical School, University of New South Wales, Sydney, NSW
- Department of Endocrinology, St Vincent’s Hospital, Sydney, NSW.
- Garvan Institute of Medical Research, Sydney, NSW
Last reviewed: November 2019
Introduction
Endocrine conditions occur commonly in HIV infection, due to specific effects of the virus, HIV-related disease, the effects of reconstitution of the immune system after the commencement of combination antiretroviral therapy (cART), complications of cART, or drug-drug interactions (Table 1).
Table 1. Endocrine disorders due to effects of HIV, HIV-related disease, immune reconstitution and drug therapy
|
Direct HIV-1 virus effects |
HIV-related disease |
Immune reconstitution |
Drug effects |
Adrenal disease |
Adrenalitis (rare) |
Infections: CMV Toxoplasmosis Mycobacterial Malignancy: KS |
Addison’s disease (rare) |
Reduced corticosteroid synthesis: antifungals (ketoconazole) Pituitary suppression: cytochrome P450 3A4 drug interactions with inhaled or oral steroids |
Thyroid disease |
|
|
Graves’ disease Hashimoto’s hypothyroidism
|
Interferon-induced thyroid disease |
Diabetes mellitus |
– |
|
|
Pentamidine-induced insulin deficiency (T1D) Insulin resistance due to protease inhibitors and NRTIs (T2D) |
Calcium metabolism |
Osteoporosis |
|
|
NRTI-related osteroporosis |
Sex hormones |
|
Androgen deficiency |
|
Androgen deficiency |