Jain Gagan, Devpura Ganpat, Gupta B S
Upgraded Department of Medicine, S.M.S. Medical College & Attached Groups of Hospitals, Jaipur, India.
J Assoc Physicians India. 2009 Jul;57:508-10.
To study thyroid function tests in patients infected with human immunodeficiency virus (HIV) infection at various stages of the illness and to correlate the results with the disease progression.
In a prevalence study of 50 HIV infected patients at various stages of illness thyroid function tests consisting of free-thyroxin (FT-4), free tri-iodothyronine (FT-3), and serum thyroid stimulating hormone (s. TSH) were done. Subjects belonged to both sexes and all subjects were newly diagnosed HIV+ patients and were not receiving antiretroviral therapy (ART) when enrolled in the study. Patients were studied in two groups: Group-1 had 25 patients having AIDS and Group-2 had 25 patients who were HIV+ but were not having AIDS as per 1993 revised CDC classification for HIV infection in adolescents and adults. The results were statistically analyzed and correlation of abnormalities in thyroid function tests with the disease progression was studied.
Out of 50 cases, thyroid function abnormalities were observed in substantial number of patients. Nine (18%) patients had FT-3 levels below the normal range, ten (20%) patients had decreased FT-4 levels and twelve (24%) patients had s. TSH levels above the normal range. When the results were statistically analyzed for the 50 patients enrolled in our study using Pearson's correlation coefficient, there was a direct correlation between CD4 count and FT3 and FT4 values (r = 0.357 with p < 0.05; r = 0.650 with p < 0.05 respectively). There was an inverse correlation of CD4 counts with serum TSH levels (r = -0.470 with p < 0.050).
Thyroid dysfunction is frequent in HIV infection and with progression of disease there is a primary hypothyroid like stage that occurs in patients with HIV infection. FT3 /FT4/serum TSH can be used as a surrogate marker of the progression of the disease.
研究处于疾病不同阶段的人类免疫缺陷病毒（HIV）感染患者的甲状腺功能测试，并将结果与疾病进展相关联。
在一项对50例处于疾病不同阶段的HIV感染患者的患病率研究中，进行了包括游离甲状腺素（FT - 4）、游离三碘甲状腺原氨酸（FT - 3）和血清促甲状腺激素（s.TSH）的甲状腺功能测试。受试者包括男性和女性，所有受试者均为新诊断的HIV +患者，在纳入研究时未接受抗逆转录病毒治疗（ART）。患者分为两组：根据1993年修订的美国疾病控制与预防中心（CDC）青少年和成人HIV感染分类标准，第1组有25例患有艾滋病的患者，第2组有25例HIV +但未患艾滋病的患者。对结果进行统计学分析，并研究甲状腺功能测试异常与疾病进展的相关性。
在50例病例中，相当数量的患者观察到甲状腺功能异常。9例（18%）患者的FT - 3水平低于正常范围，10例（20%）患者的FT - 4水平降低，12例（24%）患者的s.TSH水平高于正常范围。当使用Pearson相关系数对我们研究中纳入的50例患者的结果进行统计学分析时，CD4细胞计数与FT3和FT4值之间存在直接相关性（r = 分别为0.357，p < 0.05；r = 0.650，p < 0.05）。CD4细胞计数与血清TSH水平呈负相关（r = -0.470，p < 0.050）。
甲状腺功能障碍在HIV感染中很常见，并随着疾病进展，HIV感染患者会出现原发性甲状腺功能减退样阶段。FT3 /FT4/血清TSH可作为疾病进展的替代标志物。
