Cortisol levels and short term outcome in hiv infected patients with sepsis in Kenyatta Hospital
Date
2009Author
Otieno, C F
Amayo, E O
Kariithi, F N Keli
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
Introduction
Adrenal insufficiency occurs in Human immunodeficiency virus (HIV)/ Acquired
Immunodeficiency Syndrome (AIDS) and causes morbidity and mortality in HIV
patients.
Objective
To determine cortisol levels and short term out come at 2 weeks in HIV infected and HIV
uninfected patients admitted with sepsis in Kenyatta National hospital.
Design
This was a Cross Sectional Comparative study.
Settings
Medical wards, Intensive Care Unit, Renal Units Kenyatta National Hospital.
Subjects
Patients admitted with sepsis.
Method
Consecutive HIV infected admitted with sepsis as defined by a tool adopted from the
consensus conference held 2008 were recruited. Male or female HIV infected patient’s
aged more than 13 yrs and their age and sex matched comparative HIV negative patients
were included. A baseline cortisol test was done. Synthetic cosyntrophin was given
intravenously to stimulate the adrenal glands and serum cortisol levels at 30 and 60
minutes done following the stimulation. Patients were then followed until 2 weeks after
admission to establish their outcome. Expected outcomes were either discharge from the
hospital or death. P values of 0.005 were considered significant at confidence intervals
of 95%. Adrenal insufficiency was defined as baseline cortisol levels < 130nmol/l and or
failure to achieve cortisol levels of > 414nmol/l post stimulation.
Results
A total of 94 HIV infected and HIV uninfected patients were recruited in the study 47
patients in each group. The mean age was 36±12.2 in the HIV infected group and 37±
13.4 HIV uninfected group. There was no statistically significant difference in the
proportions of patients with adrenal insufficiency in the two groups. The prevalence of
primary adrenal insufficiency in the study and comparative groups was 19% and 25.5%
respectively.
There were more deaths in the comparative group 31.9% compared to the study group at
24%.
Conclusion
There was no significant difference of adrenal insufficiency in the study group and
comparative group in the comparative group.
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
- Faculty of Health Sciences (FHS) [10387]
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