CD4 and Adrenal insufficiency: Hyponatraemia is a common electrolyte disorder in PLWH and a possible marker of HIV severity, as patients with hyponatraemia have significantly lower CD4 counts, higher viral loads and an increased prevalence of acquired immunodeficiency syndrome (AIDS).16 In PLWH, the main causes of hyponatraemia include opportunistic infections which predispose to SIADH, adrenal insufficiency, diarrhoea and vomiting.17 Furthermore, dysfunction of the thick ascending limb of the loop of Henle secondary to HIV and inflammation results in impaired free water clearance and dilutional hyponatraemia.8,18