Sarah Patterson, Patricia Moran, Elissa Epel, Elizabeth Sinclair, Margaret E. Kemeny, Steven G. Deeks, Peter Bacchetti, Michael Acree, Lorrie Epling, Clemens Kirschbaum, Frederick M. Hecht

The level of T cell activation in untreated HIV disease is strongly and independently associated with risk of immunologic and clinical progression. The factors that influence the level of activation, however, are not fully defined. Since endogenous glucocorticoids are important in regulating inflammation, we sought to determine whether less optimal diurnal cortisol patterns are associated with greater T cell activation.