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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/mm³ 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 thyroid disorder thyroid-stimulating hormone thyroid abnormality hyperthyroidism

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References

Ankri

Bonmarchand

Coutellier

. (1999) Antiphospholipid antibodies are an epiphenomenon in HIV-I. Journal of Pediatric Endocrinology and Metabolism 13: 1282–1283.

Arnsten

Freeman

Howard

. (2007) Decreased bone mineral density and increased fracture risk in aging men with or at risk for HIV infection. AIDS 21: 617–623.

Beltran

Lescure

Esper

. (2006) Subclinical hypothyroidism in HIV-infected patients is not an autoimmune disease. Hormone Research 66: 21–26.

Beltran

Lescure

Desailloud

. (2003) Increased prevalence of hypothyroidism among human immunodeficiency virus-infected patients: a need for screening. Clinical Infectious Diseases 37: 579–783.

Botella-Carrtero

Pados

Manzano

. (2005) The effects of thyroid hormones on circulating markers of cell-mediated immune response, as studied in patients with different thyroid carcinoma before and during thyroxin withdrawal. European Journal of Endocrinology 153: 223–230.

Calza

Manfredi

Chiodo

. (2002) Subclinical hypothyroidism in HIV-infected patients receiving highly active antiretroviral therapy. Journal of Acquired Immune Deficiency Syndromes 31: 361–363.

Casau

(2005) Perspective on HIV infection and aging: emerging research on the horizon. Clinical Infectious Diseases 41: 855–863.

Collazos

Ibarra

Mayo

(2003) Thyroid hormones in HIV-infected patients in the highly active antiretroviral therapy era: evidence of an interrelation between the thyroid axis and the immune system. AIDS 17: 763–765.

Dobs

Dempsey

Ladenson

. (1998) Endocrine disorders in men infected with human immunodeficiency virus. American Journal of Medicine 84: 611–616.

10.

Dupont

Plummer

(1990) Power and sample size calculations: a review and computer program. Controlled Clinical Trials 11: 116–128.

11.

Friis Moller

Sabin

Weber

. (2003) Combination of antiretroviral therapy and the risk of myocardial infarction. New England Journal of Medicine 349: 1993–2003.

12.

Grappin

Piroth

Verges

. (2000) Increased prevalence of subclinical hypothyroidism in HIV patients treated with highly active antiretroviral therapy. AIDS 14: 1070–1072.

13.

Grunfeld

Pang

Doerrier

. (1993) Indices of thyroid function and weight loss in human immunodeficiency virus infection and the acquired immunodeficiency syndrome. Metabolism 42: 1270–1276.

14.

Hoffmann

Brown

(2007) Thyroid function abnormalities in HIV-infected patients. Clinical Infectious Diseases 45: 488–494.

15.

Jain

Devpura

Gupta

(2009) Abnormalities in the thyroid function test as surrogate marker of advancing HIV infection in infected adults. Journal of Association of Physicians of India 57: 508–510.

16.

Klecha

Genaro

Gorelik

. (2006) Integrative study of hypothalamus-pitutary-thyroid-immune system interaction: thyroid hormone-mediated modulation of lymphocyte activity through the protein kinase C signaling pathway. Journal of Endocrinology 189: 45–55.

17.

Klecha

Genaro

Lysionek

. (2000) Experimental evidence pointing to the bidirectional interaction between the immune system and the thyroid axis. International Journal of Immunopharmacology 22: 491–500.

18.

Komorowski

Stepien

Pawilowski

. (1993) The evidence of thyroliberin / triiodothyronine control of TSH secretary response from human peripheral blood monocytes cultured in vittro. Neuropeptides 25: 31–34.

19.

Lin

Martino

Wilcox

. (1998) Potentiation by thyroid hormone of human IFN-gamma-induced HLA-DR expression. Journal of Immunology 16: 843–849.

20.

Madeddu

Spanu

Chessa

. (2006) Thyroid function in human immunodeficiency virus patients treated with highly active antiretroviral therapy. Clinical Endocrinology (Oxford) 64: 375–383.

21.

Madge

Smith

Lamp

. (2006) No association between HIV disease and its treatment and thyroid function. HIV Medicine 7(supp 1): 23 abstract p49.

22.

Marik

Kiminyo

Zaloga

. (2002) Adrenal insufficiency in critically ill patients with human immunodeficiency virus. Critical Care Medicine 30: 1267–1273.

23.

Meena

Rai

Singh

. (2011) Endocrine changes in male HIV patients. Journal of Association of Physicians of India, 59: 2–3.

24.

Merenich

McDemott

Asp

. (1990) Evidence of endocrine involvement early in the course of human immunodeficiency virus infection. Journal of Clinical Endocrinology and Metabolism 70: 566–571.

25.

Montero

Giovannoni

Fernandez

. (1998) Autoantibodies in immunodeficiency virus-infected patients with and without concurrent hepatitis C infection. Arthritis and Rheumatism 41: 2077–2080.

26.

Olivieri

Sorcini

Battisti

. (1993) Thyroid function related with the progression of human immunodeficiency virus infection. Journal of Endocrinology Investigation 16: 407–413.

27.

Quirino

Bongiovannt

Ricci

. (2003) Hypothyroidism in HIV-infected patients who have or have not received HAART. Clinical Infectious Diseases 38: 596–597.

28.

Raffi

Brisseau

Planchon

. (1991) Endocrine function in 98 HIV–infected patients: a prospective study. AIDS 5: 729–733.

29.

Viard

Chabre

Bach

. (1994) Autoantibodies to nucleosomes in HIV-infected patients. Journal of Acquired Immune Deficiency Syndromes 7: 1286–1287.

30.

Vinayagamoorthi

Koner

Kavitha

. (2005) Potentiation of humoral immune response and activation of NF-kappa B pathway in lymphocytes in experimentally induced hyperthyroid rats. Cellular Immunology 238: 56–60.

31.

Yen

(2001) Phsyological and molecular basis of thyroid hormone action. Physiological Reviews 81: 1097–1142.

32.

Wiener

Klein

(2008) Abnormal thyroid function in older men with or at a risk for HIV infection. HIV Medicine 9: 544–549.

Thyroid function in newly diagnosed HIV-infected patients