THYROID DYSFUNCTION IN HUMAN IMMUNODEFICIENCY VIRUS INFECTED PATIENTS AND THEIR CORRELATION WITH CD4 COUNT - A NON-RANDOMIZED, CROSS-SECTIONAL, SINGLE-CENTER STUDY

Abstract

Background: Thyroid dysfunction has been reported in human immunodeficiency virus (HIV)-infected individuals. Objective: Objectives of this non-randomized, cross-sectional, single-center study was to study thyroid function in HIV positive patients at various stages of disease and to correlate the results obtained with CD4+ counts. Materials and Methods: This single-center study was carried out at Al-Ameen Medical College Hospital and Government District Hospital Bijapur, Karnataka, India from November 2020 to December 2022. The final selected study population included newly diagnosed adult and adolescent (17-60 years) HIV+ patients was composed of 100 participants of either gender. Patients were interviewed &enrolled in the study after examining in detail according to the proforma and then by taking their written consent and explaining the purpose of the study. The Thyroid hormone assays (S.TSH, FT3 and FT4) were done by Chemiluminescencelmmuno Assay (CLIA) using ADVIA Centaur-equipment.The CD4+ T-cell count was completed using FACS Calibur, Beckton Dickinson, USA27. Results: Overall mean age was 36 years (range in years: 17 – 66 years) and 66 patients (66%) were males.Male:Female ratio of 1.94:1 was recorded. Among 50 cases having CD4+ count <200/pl there were 38(76%) males and 12(24%) females. Among 50 cases having CD4 count >200/pl there were 28(56%) males and 22(44%) females.The CD4+ count ranged from 5 to 773/pl with a mean of 223±190.9/pl. This study observed that abnormalities of thyroid function are more common among patients having CD4+ count <200/pl. Clinically evident hyperthyroidism was not observed in any case.Direct correlation was observed between CD4 count and FT3 and FT4 values and Inverse correlation was observed when CD4+ counts were compared with serum TSH levels. Conclusion: All individuals with CD4 count less than 200 should be screened for hypothyroidism.An inverse correlation was seen between TSH and CD4 count indicating trend for hypothyroidism as HIV disease progress.