ArticleJournal of acquired immune deficiency syndromes (1999)2013
High frequency of hypothalamic-pituitary-adrenal axis dysfunction after local corticosteroid injection in HIV-infected patients on protease inhibitor therapy.
Article in Journal of acquired immune deficiency syndromes (1999), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 27 citations in OpenAlex.
- Prevalence of Adrenal Insufficiency in Clinically Stable Adults Living with HIV Attending Outpatient Clinics in Malaysia.Journal of the ASEAN Federation of Endocrine Societies · 2026Article
- Association of antiretroviral therapy regimens with serum cortisol abnormalities in people living with HIV/AIDS: a retrospective study.Frontiers in endocrinology · 2026Article
- Efficacy/Safety of the Use of Glucocorticoids in Oral and Maxillofacial Surgery.Dentistry journal · 2023Review
- Long-Term Usage of Oral Glucocorticoids Leading to Adrenal Insufficiency: A Comprehensive Review of the Literature.Cureus · 2023Review
- Human Immunodeficiency Virus Infection and the Endocrine System.Endocrinology and metabolism (Seoul, Korea) · 2019Review
- Adrenal disorders in people with HIV: The highs and lows.The Indian journal of medical research · 2018Article
- Iatrogenic Cushing's syndrome due to drug interaction between glucocorticoids and the ritonavir or cobicistat containing HIV therapies.Clinical medicine (London, England) · 2016Article
- The evolution of three decades of antiretroviral therapy: challenges, triumphs and the promise of the future.British journal of clinical pharmacology · 2015Review
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Authors and funding
9 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundThe frequency of hypothalamic-pituitary-adrenal axis dysfunction among HIV-infected patients receiving steroid injections has not been reported, and the risk factors for this adverse event are poorly characterized.
methodsWe conducted a retrospective analysis of data from HIV-infected patients in the Partners HealthCare system (Boston, MA) who received corticosteroid injection(s) between 2002 and 2011. Chart review focused on HIV status, antiretroviral therapy [eg, protease inhibitors (PI)], steroid injection(s), and adrenal axis dysfunction (eg, adrenal insufficiency and/or Cushing syndrome). Because all cases occurred among patients on PIs, we performed additional detailed data extraction and conducted univariate and multivariate analyses to identify risk factors in this group.
resultsOne hundred seventy-one HIV-infected patients received ≥1 corticosteroid injection(s) in the study period. Nine cases (event frequency: 5.3%; 95% confidence interval: 2.4% to 9.8%) of secondary adrenal insufficiency were diagnosed; 5 (55%) of these 9 patients also had clinical evidence of Cushing syndrome. All cases occurred among the 81 patients on PIs (event frequency among those on PIs: 11.1%; 95% confidence interval: 5.2% to 20.0%). Among patients on PIs, the major risk factor for hypothalamic-pituitary-adrenal axis dysfunction was having ≥2 injections within 6 months.
conclusionsIn this retrospective cohort study, 11% of HIV-infected patients on PIs at the time of steroid injection were later diagnosed with hypothalamic-pituitary-adrenal axis dysfunction. Corticosteroid injections in HIV-infected patients on PIs should only be used with great caution and close monitoring.
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