Prevalence and Predictors of Thyroid Dysfunction in Patients with HIV Infection and Acquired Immunodeficiency Syndrome: An Indian Perspective

IF 1.7 Q4 ENDOCRINOLOGY & METABOLISM Journal of Thyroid Research Pub Date : 2015-12-22 DOI:10.1155/2015/517173
N. Sharma, Lokesh Sharma, D. Dutta, A. K. Gadpayle, A. Anand, K. Gaurav, S. Mukherjee, R. Bansal
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引用次数: 22

Abstract

Background. Predictors of thyroid dysfunction in HIV are not well determined. This study aimed to determine the prevalence and predictors of thyroid dysfunction in HIV infected Indians. Methods. Consecutive HIV patients, 18–70 years of age, without any severe comorbid state, having at least 1-year follow-up at the antiretroviral therapy clinic, underwent clinical assessment and hormone assays. Results. From initially screened 527 patients, 359 patients (61.44 ± 39.42 months' disease duration), having good immune function [CD4 count >200 cell/mm3: 90.25%; highly active antiretroviral therapy (HAART): 88.58%], were analyzed. Subclinical hypothyroidism (ScH) was the commonest thyroid dysfunction (14.76%) followed by sick euthyroid syndrome (SES) (5.29%) and isolated low TSH (3.1%). Anti-TPO antibody (TPOAb) was positive in 3.90%. Baseline CD4 count had inverse correlation with TPOAb after adjusting for age and body mass index. Stepwise linear regression revealed baseline CD4 count, TPOAb, and tuberculosis to be best predictors of ScH after adjusting for age, weight, duration of HIV, and history of opportunistic fungal and viral infections. Conclusion. Burden of thyroid dysfunction in chronic HIV infection with stable immune function is lower compared to pre-HAART era. Thyroid dysfunction is primarily of nonautoimmune origin, predominantly ScH. Severe immunodeficiency at disease onset, TPOAb positivity, and tuberculosis were best predictors of ScH.
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艾滋病毒感染和获得性免疫缺陷综合征患者甲状腺功能障碍的患病率和预测因素:印度视角
背景。HIV患者甲状腺功能障碍的预测因素尚未确定。本研究旨在确定印度HIV感染者甲状腺功能障碍的患病率和预测因素。方法。连续的HIV患者,年龄18-70岁,无任何严重合并症,在抗逆转录病毒治疗诊所随访至少1年,接受临床评估和激素检测。结果。从最初筛选的527例患者中,359例患者(病程61.44±39.42个月)免疫功能良好[CD4计数>200细胞/mm3: 90.25%;高活性抗逆转录病毒治疗(HAART): 88.58%]。亚临床甲状腺功能减退(ScH)是最常见的甲状腺功能障碍(14.76%),其次是病态甲状腺功能正常综合征(SES)(5.29%)和孤立性低TSH(3.1%)。抗tpo抗体(TPOAb)阳性率为3.90%。在调整年龄和体重指数后,基线CD4计数与TPOAb呈负相关。逐步线性回归显示,在调整年龄、体重、HIV持续时间以及机会性真菌和病毒感染史后,基线CD4计数、TPOAb和结核病是ScH的最佳预测因子。结论。与haart前相比,免疫功能稳定的慢性HIV感染者甲状腺功能障碍负担较低。甲状腺功能障碍主要是非自身免疫性的,主要是ScH。发病时严重免疫缺陷、TPOAb阳性和结核病是ScH的最佳预测因子。
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来源期刊
Journal of Thyroid Research
Journal of Thyroid Research ENDOCRINOLOGY & METABOLISM-
CiteScore
4.40
自引率
0.00%
发文量
10
审稿时长
17 weeks
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