CORTISOL-LEVELS, IMMUNE STATUS, AND MOOD IN HOMOSEXUAL MEN WITH AND WITHOUT HIV-INFECTION

Objective: Alteration in cortisol levels has been reported in HIV infe ction and may be related to levels of psychiatric distress and immune function. The goals of this study were to assess cortisol levels in su bjects with HIV infection and to determine whether stress-related acti vation of the hypothalamic-pituitary-adrenal (HPA) axis results in com promised immune function. Method: As part of a longitudinal study, the authors assessed urinary free cortisol levels of HIV-positive and HIV -negative homosexual men at four time points during a period of 2 year s. Subjects' scores on the Hamilton depression and anxiety rating scal es, medical stage of HIV infection, and CD4+ and CD8+ cell counts were also assessed. Repeated measures analysis of variance was used to det ermine whether subjects' cortisol levels at the four time points diffe red according to their serological status. Pearson correlation coeffic ients were computed to examine the relationships among mood ratings, c ortisol levels, medical stages, and cell counts. Results: Cortisol lev els did not differ significantly between the HIV-positive and the HIV- negative subjects and were not associated with stage of medical illnes s in HIV infection. An association between cortisol level and depresse d and anxious mood was found only at the first assessment. Cortisol le vel was not associated with CD4+ cell count in either group of subject s. Conclusions. There were no significant elevations of cortisol level s in the HIV-infected subjects, nor was there consistent evidence for stress-related activation of the HPA axis in either the HIV-positive o r the HIV-negative subjects.