Journal of Endocrinological Investigation

, Volume 41, Issue 8, pp 881–899 | Cite as

Endocrinological aspects of HIV infection

  • F. S. MirzaEmail author
  • P. Luthra
  • L. Chirch



Patients with human immunodeficiency virus (HIV) are living longer with effective antiretroviral therapies and are enjoying near normal life span. Therefore, they are encountering endocrine issues faced by the general population along with those specific to HIV infection. The purpose of this article is to review the common endocrine aspects of HIV infection, and the early detection and management strategies for these complications.


Recent literature on HIV and endocrine disease was reviewed.


HIV can influence endocrine glands at several levels. Endocrine glandular function may be altered by the direct effect of HIV viral proteins, through generation of systemic and local cytokines and the inflammatory response and via glandular involvement with opportunistic infections and HIV-related malignancies. Endocrine disorders seen in people with HIV include metabolic issues related to obesity such as diabetes, hyperlipidemia, lipohypertrophy, lipoatrophy and lipodystrophy and contribute significantly to quality of life, morbidity and mortality. In addition, hypogonadism, osteopenia and osteoporosis are also more prevalent in the patients with HIV. Although disorders of hypothalamic–pituitary–adrenal axis resulting in adrenal insufficiency can be life threatening, these along with thyroid dysfunction are being seen less commonly in the antiretroviral therapy (ART) era. ARTs have greatly improved life expectancy in people living with HIV but can also have adverse endocrine effects.


Clinicians need to have a high index of suspicion for endocrine abnormalities in people with HIV as they can be potentially life threatening if untreated. Endocrine evaluation should be pursued as in the general population, with focus on prevention, early detection and treatment to improve quality of life and longevity.


Human immunodeficiency virus Antiretroviral therapy Endocrinopathy Bone disease Lipodystrophy Diabetes Hyperlipidemia 



The authors thank Professor Ernesto Canalis and Ms. Mary Yurczak for their support of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors do not have any disclosures.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

No informed consent.


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Copyright information

© Italian Society of Endocrinology (SIE) 2018

Authors and Affiliations

  1. 1.Division of Endocrinology and Metabolism, Department of MedicineUConn HealthFarmingtonUSA
  2. 2.Division of Infectious DiseasesUConn HealthFarmingtonUSA
  3. 3.Department of MedicineUConn HealthFarmingtonUSA

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