NO INCREASED PREVALENCE OF ADRENOCORTICAL INSUFFICIENCY IN HUMAN IMMUNODEFICIENCY VIRUS-ASSOCIATED TUBERCULOSIS

Setting: Acute medical wards, Kenyatta National Hospital, Nairobi, Ken ya, Objective: To determine the prevalence of adrenocortical insuffici ency in human inmunodeficiency virus (HIV)-1 infected and non-infected patients with tuberculosis, Design: One hundred and seventy-four pati ents with proven tuberculosis (90 HIV-1 positive and 84 HIV-1 negative ) were assessed for adrenocortical insufficiency with a 30 min synacth en stimulation test, Results: Fifty-one percent of those with pulmonar y tuberculosis and 56% of those with extra-pulmonary tuberculosis had a subnormal cortisol response. However there was no statistically sign ificant difference between the HIV-1 infected and non-infected patient s in either group, Conclusion: While an impaired cortisol response is common in tuberculosis, it is no more prevalent in HIV-1 infected pati ents than non-infected patients with tuberculosis.