Study of Prevalence of Thyroid Dysfunction in Seropositive HIV Patients

INTRODUCTION: Several endocrinopathies have been reported to be associated with HIV infection when the CD4 count is low. So before the advent of HAART, subclinical and clinical thyroid, adrenal and gonadal disturbances have been identified. An abnormal thyroid function test results are seen among human immunodeficiency virus (HIV) infected patients and is caused by various mechanisms such as infiltration of the gland by opportunistic infections or a systemic manifestation of the infection itself. This causes subclinical Hypothyroidism which is a precursor to overt hypothyroidism. Subclinical hypothyroidism is associated with only mild clinical abnormalities and is characterised by normal T4 values but with elevation in thyroid-stimulating hormone (TSH). Specific thyroid function test abnormalities are identified among HIV-infected patients. But the incidence of overt thyroid illness is same as that of the general population Among the HIV patients: Overt thyroid disease 1-2%. Subtle abnormalities in thyroid function test 35%. Thyroid abnormalities in HIV-infected patients are dealt in detail in this study. AIMS AND OBJECTIVES; To evaluate patients with human immunodeficiency virus (HIV) infection for the prevalence of thyroid dysfunction and to correlate the results with the CD4 count. MATERIALS AND METHODS: STUDY POPULATION: This study is to be conducted among 50 patients with Seropositive HIV, attending the Department of Medicine & ART Centre in Govt. Rajaji Hospital, Madurai. STUDY PROTOCOL: In Patients of HIV Positive on ART, both sex, T3, T4, TSH, CD4 Count are done. Results are then analysed. RESULTS: People with CD4 count between 100- 200 were having a mean TSH value of 8.45+/-0.32 and people with CD4 less than <100 were having TSH values 9.75+/-0.39 (p= <.001) and there is no significant correlation between thyroid dysfunction and patients on HAART CONCLUSIONS: Thyroid dysfunction is found in significant association with HIV infection and a hypothyroid state occurs in HIV infection as the disease progresses. Males and females suffering from HIV show equal incidence of thyroid dysfunction. All individuals with CD4 count less than 200 should be screened for hypothyroidism. In individuals with a low CD4 count, a lower BMI is observed as compared to other patients with CD4 counts higher than them. There is no significant correlation between thyroid dysfunction and patients treated with HAART