Blood cortisol and dehydroepiandrosterone sulphate (DHEAS) levels and CD4 T cell counts in HIV infection

Objective. Blood cortisol and dehydroepiandrosterone sulphate (DHEAS) levels, and CD4 T cell counts were assessed in a group of 44 patients with HN infection (17 asymptomatic and 27 symptomatic), The steroid levels were compared to those in 80 healthy subjects. Results. The mean cortisol level did not differ between the HIV patients and controls. However, a broad variability existed among the patients; thus, asymptomatic HIV patients revealed a significantly higher mean level than the controls (348 nmol/l vs, 280 nmol/l; p < 0.01). Furthermore, 20 patients had levels above, 16 within, and 8 below the confidence limits of the cortisol levels in controls. This variability might reflect differences in adrenocortical responses To psychological stress and adaptive reactions among patients with HIV infection. The mean DHEAS was markedly lowered in the patient group (1450 nmol/l in patients vs. 3300 nmol/l in controls; p < 0.001). A decrease below the confidence limits of the controls existed in 41 (93%) of the 44 patients. A significant correlation was also found between the low DHEAS levels and low CD4 T cell counts in the patients (p < 0.01), while no such correlation existed for cortisol. Conclusion. Whether low DHEAS levels might contribute to some of the pathophysiologic features and/or symptoms seen in HIV infection needs to be investigated.