Thyroid function in newly diagnosed HIV-infected patients

Toxicol Ind Health. 2014 Nov;30(10):919-25. doi: 10.1177/0748233712466133. Epub 2012 Nov 27.

Abstract

Background: A variety of HIV-related endocrine dysfunctions including adrenal, gonadal and thyroid disorders have been reported. We aimed to compare between the markers of thyroid function in newly diagnosed HIV-infected patients and healthy volunteers as a control group. The prevalence of the thyroid abnormalities in HIV-infected patients was assessed and the levels of thyroid autoantibodies were also determined.

Methods: A total of 100 newly diagnosed HIV-infected patients having a CD4 cell count of 180-350 cells/mm(3) were enrolled in the study. Same number of healthy volunteers were also included for comparison. Measurements of thyroid function tests including thyroid-stimulating hormone (TSH), free thyroxin and free triiodothyronine levels beside thyroid autoantibodies, including antithyroglobulin (ATBG) and antithyroid peroxidase (ATPO), were carried out for all patients and volunteers.

Results: In total, 70% of HIV-infected patients had normal thyroid function tests when compared with control individuals, while 30% of HIV-infected patients had abnormal thyroid function. Of the 30 cases, 11 cases had abnormal TSH values, with increased TSH predominant (7% of HIV cases) than decreased TSH (4% of patients) values. Incidence of thyroid abnormalities ranging from hypothyroidism (subclinical and overt: 6% and 1%, respectively) to hyperthyroidism (2%) and nonthyroidal illness (9%) were estimated in HIV-infected patients. The values of thyroid autoantibodies were almost normal in HIV-infected patients, except the three cases presented with elevated ATBG, indicating that thyroid abnormalities were not due to elevated ATBG and ATPO.

Conclusions: Thyroid hormones are of great importance and due to high prevalence of thyroid function abnormality, it is recommended that thyroid function tests should be monitored in all HIV-infected patients before starting the treatment.

Keywords: Endocrine dysfunction; hyperthyroidism; thyroid abnormality; thyroid disorder; thyroid-stimulating hormone.

MeSH terms

  • Adult
  • Case-Control Studies
  • Female
  • HIV Infections / blood
  • HIV Infections / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Thyroid Function Tests
  • Thyroid Gland / physiopathology*
  • Thyrotropin / blood
  • Young Adult

Substances

  • Thyrotropin