To determine the prevalence of thyroid dysfunction, pattern and autoimmune status among HIV/AIDS patients compared to HIV-negative controls.
The study was cross-sectional hospital-based comparative with consecutive recruitment of HIV / AIDS patients and HIV negative patients attending the Aminu Kano Teaching Hospital PEPFAR / HIV clinic and GOPD respectively. Study duration was 6 months. Demographic data, relevant history suggestive of thyroid dysfunction, anthropometry and blood pressure measurements, and thyroid examination were undertaken and captured in an interviewer-administered questionnaire. Laboratory data evaluated include thyroid function tests, anti-TPO antibodies, fasting plasma glucose, CD4 cell count, viral load, plasma lipids, and complete blood count.
A total of 115 HIV positive and 115 HIV negative subjects (20% males, and 80% females) in both groups were recruited and evaluated. The mean ± SD age of the subjects and controls was 38.2±9.54years and 35.9±13.57years respectively, p=0.138. The prevalence of thyroid dysfunction among the subjects and controls was 32.7% and 34.5% respectively, p=0.775. The predominant form of thyroid disorder identified was primary hypothyroidism, followed by isolated low FT3 among the subjects; while subclinical hypothyroidism followed by primary hypothyroidism is the predominant abnormality among the controls. Thyroid autoimmunity was demonstrated in 14.5% of subjects and 13.6% controls, p=0.846.
Discussion : •Our prevalence is similar to what was found by Shujing Ji in Guangzhou, China; •Its lower than those reported by Gulherme in Rio de Janeiro, Brazil and K Amadi in Jos, Nigeria. • •Its however higher than those reported by Sen. P in Rio de Janeiro, Brazil and many other studies. •Similar finding of hypothyroidism as the most common abnormality was by Shujing Ji in China. •It is in contrast to finding of Collazes in Spain who reported subclinical hyperthyroidism as the most common abnormality. Isolated low FT4 was found by Rasoolinejad in Tehran, Iran. •Thaimata in Nairobi, Kenya reported sick euthyroid syndrome and •Abbiyesuku in Ibadan, Nigeria reported isolated low FT3 (9%) and isolated low FT4 (9%) as the most common abnormalities among their cases.
The predominant form of thyroid disorder among HIV/AIDS patients was primary hypothyroidism, while subclinical hypothyroidism predominated in non-HIV / AIDS patients. The prevalence of anti-TPO antibodies among HIV infected subjects and HIV-negative controls appear to be quite similar. Screening for thyroid disorders in patients with HIV / AIDS may not be recommended.
Abubakar Usman– CONSULTANT, AMINU KANO TEACHING HOSPITAL