LOW ADRENAL ANDROGENS IN MEN WITH HIV-INFECTION AND THE ACQUIRED-IMMUNODEFICIENCY-SYNDROME

Using gas chromatography and mass spectrometry we have studied the rat ios of steroid metabolites and 24-hour urinary steroid excretion rates in 37 men of whom 14 where positive for the human immunodeficiency vi rus (HIV; group A), while 9 had acquired immunodeficiency syndrome (AI DS; group B). Controls were sick non-AIDS patients admitted to an inte nsive care unit (ICU) and healthy volunteers. In groups A and B and th e ICU controls, there was a reduction in the excretion of adrenal andr ogen metabolites and a reduced ratio of 5 alpha to 5 beta androgen met abolites. These data suggest that adrenal androgens are removed in HIV and AIDS in a similar manner to other systemic illnesses. In group B patients and the sick controls, the ratios of cortisol to cortisone me tabolites were raised compared with controls. Daily, total cortisol me tabolite excretion rates in AIDS were similar to those in patients in the ICU. The selective loss of adrenal androgens may be mediated by cy tokines and influence components of the immune system. The progression of HIV to AIDS may be due in part to an imbalance between androgens a nd glucocorticoids.