Abstract

Introduction: Hormonal abnormality is one of many clinical manifestations of HIV infections that is not well understood. However, the consequences could affect quality of life and are potentially treatable. Thus, this study aimed to determine the prevalence and associated factors of thyroid, adrenal and gonadal dysfunctions among HIV-infected patients. Methods: This is a single centre cross-sectional study involving 150 HIV-infected patients attending the HIV clinic. Each subject was required to answer specific symptoms questionnaire and their medical records were reviewed for relevant clinical and biochemical data. Blood for was collected and thyroid hormones, cortisol, ACTH, FSH, LH, testosterone and estradiol were analysed using electrochemiluminescent immunoassay. Thyroid, adrenal and gonadal axes abnormalities were identified. Results: Hypogonadism had the highest prevalence amongst the endocrine abnormalities, which was detected in 23 patients (15.3%), followed by thyroid dysfunction in 18 patients (12%) and hypocortisolism in 2 patients (1.3%). There was significant correlation between CD4 count, BMI and age with the hormone levels. Conclusion: Prevalence of endocrine abnormalities was low in these well-treated HIV-positive patients, with hypogonadism being the most common. However, significant correlations between CD4 count, age and BMI with the hormonal levels were detected. Clinical symptoms in relation to endocrinopathy are not specific as a screening tool thus underscoring the need for biochemical tests to identify these treatable conditions.

Highlights

  • Hormonal abnormality is one of many clinical manifestations of HIV infections that is not well understood

  • This study showed a relatively low prevalence of endocrine abnormalities, which could possibly be due to the good treatment (HAART) these patients were receiving

  • The overall findings of low prevalence of endocrine abnormalities, and hypogonadism as the main endocrine abnormality, are consistent with several other studies elsewhere, which found hypogonadism as the most common finding followed by thyroid dysfunction and hypocortisolism [1, 3,4,5]

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Summary

Introduction

Hormonal abnormality is one of many clinical manifestations of HIV infections that is not well understood. This study aimed to determine the prevalence and associated factors of thyroid, adrenal and gonadal dysfunctions among HIV-infected patients. Endocrine abnormalities in the form of adrenal, thyroid and gonadal abnormalities have been reported amongst patients with HIV infections in both early and advanced stages of the disease [1]. These abnormalities may manifest as mild biochemical changes or overt glandular failure, resulting in loss of muscle mass, sexual dysfunction, abnormal fat distribution and reduction in quality of life [1]. There are substantial data and epidemiological studies on hormone abnormalities among HIV-infected patients along with associated factors contributing to the endocrinopathies. The varying prevalence in previous reports and conflicting results on associated factors make it difficult to come up with general recommendations regarding interventions with hormone replacements in HIV-infected patients with hormone imbalance

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