Correlation of CD4 count with Thyroid function test values in treatment naive HIV-infected patients.

Abstract

Introduction    Abnormalities in thyroid function tests have been described in HIV patients since the early days of the HIV pandemic. There have been only a handful of studies correlating the CD4 count with different aspects of commonly done thyroid function tests. Objective To study correlation between CD4 count and thyroid function tests in treatment naive HIV-infected patients. Methodology The current study was conducted on 100  (one hundred) treatment-naive newly diagnosed HIV patients without any co infections or therapy for any other disease, over one year. Results   64 % of the patients in the study group were euthyroid with subclinical hypothyroidism being the commonest thyroid abnormality. Thyroid dysfunction was commoner in the later stages of the disease. There was no statistical significance between CD4 count and Free T4 and Free T3 values; however low CD4 count had a negative correlation with TSH values in patients with overt primary hypothyroidism which was statistically significant only in the subgroup of patients with CD4 values < 200/µl (p<0.00001). Conclusion: Treatment naive HIV patients are mostly euthyroid but thyroid hypofunction is common in the advanced form of the disease with the subgroup of CD4 count <200/µl having higher TSH values of statistical significance in patients with overt primary hypothyroidism. This probably reflects an attempt by an intact pituitary-thyroid axis to maintain homeostasis in a severe immunodeficiency state with the production of active hormones in the thyroid gland being affected by multiple factors including infections, malignancies, and micronutrient deficiency.