Am J Psychiatry 1993; 150:1674-1678
Copyright © 1993 by American Psychiatric Association
Cortisol levels, immune status, and mood in homosexual men with and without HIV infection
RM Kertzner, R Goetz, G Todak, T Cooper, SH Lin, MM Reddy, H Novacenko, JB Williams, AA Ehrhardt and JM Gorman
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, New York.
OBJECTIVE: Alteration in cortisol levels has been reported in HIV infection
and may be related to levels of psychiatric distress and immune function.
The goals of this study were to assess cortisol levels in subjects with HIV
infection and to determine whether stress-related activation of the
hypothalamic-pituitary-adrenal (HPA) axis results in compromised 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 years. Subjects' scores on the
Hamilton depression and anxiety rating scales, medical stage of HIV
infection, and CD4+ and CD8+ cell counts were also assessed. Repeated
measures analysis of variance was used to determine whether subjects'
cortisol levels at the four time points differed according to their
serological status. Pearson correlation coefficients were computed to
examine the relationships among mood ratings, cortisol levels, medical
stages, and cell counts. RESULTS: Cortisol levels did not differ
significantly between the HIV-positive and the HIV-negative subjects and
were not associated with stage of medical illness in HIV infection. An
association between cortisol level and depressed and anxious mood was found
only at the first assessment. Cortisol level was not associated with CD4+
cell count in either group of subjects. CONCLUSIONS: There were no
significant elevations of cortisol levels in the HIV-infected subjects, nor
was there consistent evidence for stress-related activation of the HPA axis
in either the HIV-positive or the HIV-negative subjects.
