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Journal of Thyroid Research
Volume 2015, Article ID 517173, 9 pages
http://dx.doi.org/10.1155/2015/517173
Research Article

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

1Department of Biochemistry, Post Graduate Institute of Medical Education & Research (PGIMER) and Dr. Ram Manohar Lohia (RML) Hospital, 1 Baba Kharak Singh Marg, New Delhi 110001, India
2Department of Endocrinology, Post Graduate Institute of Medical Education & Research (PGIMER) and Dr. Ram Manohar Lohia (RML) Hospital, 1 Baba Kharak Singh Marg, New Delhi 110001, India
3Post Graduate Institute of Medical Education & Research (PGIMER) and Dr. Ram Manohar Lohia (RML) Hospital, 1 Baba Kharak Singh Marg, New Delhi 110001, India
4Anti-Retroviral Therapy Clinic, Post Graduate Institute of Medical Education & Research (PGIMER) and Dr. Ram Manohar Lohia (RML) Hospital, 1 Baba Kharak Singh Marg, New Delhi 110001, India

Received 27 September 2015; Accepted 1 December 2015

Academic Editor: Noriyuki Koibuchi

Copyright © 2015 Neera Sharma et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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 ( 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.