Prevalence of thyroid dysfunction and its correlation with CD4 count in newly-diagnosed HIV-positive adults--a cross-sectional study

Int J STD AIDS. 2015 Nov;26(13):965-70. doi: 10.1177/0956462414563776. Epub 2014 Dec 12.

Abstract

Prevalence of subclinical hypothyroidism in HIV-positive patients is reported to be high in those with severe immune deficiency. However, there is paucity of literature in newly-diagnosed HIV-positive population. Our aim was to estimate the prevalence of thyroid dysfunction and study its correlation with CD4 count in this population. In this cross-sectional study, patients presenting to the antiretroviral therapy clinic were screened with thyroid function tests, including thyroid stimulating hormone, free triiodothyronine, free thyroxine, and anti-thyroid peroxidase antibody levels at the time of diagnosis. Two hundred and twenty-five HIV-positive and an equal number of healthy volunteers were enrolled. The mean (SD) CD4 count in the study group was 147.1 (84) and 70.7% had advanced immune deficiency with CD4 count <200 cells/µL. The overall prevalence of thyroid dysfunction was 75.5% in the study group and 16% in the control group. Subclinical hypothyroidism was the commonest abnormality noted in almost 53%. Significant correlation was observed between CD4 count and thyroid stimulating hormone, free triiodothyronine, and free thyroxine levels (r = -0.86, r = 0.77, and r = 0.84, respectively, p < 0.0001 for all). The present study demonstrated high prevalence of thyroid dysfunction in HIV-positive patients. The dysfunction is subclinical in most cases and correlates well with declining CD4 counts.

Keywords: AIDS; CD4 count; HIV; T3; T4; anti-thyroid peroxidase antibody; endocrine; free thyroxine; free triiodothyronine; thyroid; thyroid stimulating hormone.

MeSH terms

  • Adult
  • CD4 Lymphocyte Count*
  • Case-Control Studies
  • Cross-Sectional Studies
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • HIV Infections / blood
  • HIV Infections / diagnosis*
  • HIV Infections / physiopathology
  • Humans
  • Hyperthyroidism / diagnosis
  • Hyperthyroidism / epidemiology
  • Hypothyroidism / diagnosis
  • Hypothyroidism / epidemiology
  • Male
  • Middle Aged
  • Prevalence
  • Thyroid Diseases / diagnosis*
  • Thyroid Diseases / epidemiology*
  • Thyroid Function Tests
  • Thyroid Gland / immunology
  • Thyroid Gland / physiopathology
  • Thyroid Hormones / blood*
  • Thyrotropin / blood
  • Thyroxine / blood
  • Triiodothyronine / blood

Substances

  • Thyroid Hormones
  • Triiodothyronine
  • Thyrotropin
  • Thyroxine