Ige Olusoji Mayowa, Akinlade Kehinde Sola, Rahamon Sheu Kadiri, Edem Victory Fabian, Arinola Olatunbosun Ganiyu
Department of Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria.
Deaprtment of Chemical Pathology, University of Ibadan/University College Hospital, Ibadan, Nigeria.
Afr Health Sci. 2016 Jun;16(2):596-602. doi: 10.4314/ahs.v16i2.30.
Mycobacterium tuberculosis and human immunodeficiency virus (HIV) are known to cause abnormal thyroid function. There is little information on whether HIV infection aggravates alteration of thyroid function in patients with MDR-TB.
This study was carried out to determine if HIV co-infection alters serum levels of thyroid hormones (T3, T4) and thyroid stimulating hormone (TSH) in patients with MDR-TB patients and to find out the frequency of subclinical thyroid dysfunction before the commencement of MDR-TB therapy.
This observational and cross-sectional study involved all the newly admitted patients in MDR-TB Referral Centre, University College Hospital, Ibadan, Nigeria between July 2010 and December 2014. Serum levels of thyroid stimulating hormone (TSH), free thyroxine (fT4) and free triiodothyronine (fT3) were determined using ELISA.
Enrolled were 115 patients with MDR-TB, out of which 22 (19.13%) had MDR-TB/HIV co-infection. Sick euthyroid syndrome (SES), subclinical hypothyroidism and subclinical hyperthyroidism were observed in 5 (4.35%), 9 (7.83%) and 2 (1.74%) patients respectively. The median level of TSH was insignificantly higher while the median levels of T3 and T4 were insignificantly lower in patients with MDR-TB/HIV co-infection compared with patients with MDRT-TB only.
It could be concluded from this study that patients with MDR-TB/HIV co-infection have a similar thyroid function as patients having MDR-TB without HIV infection before commencement of MDR-TB drug regimen. Also, there is a possibility of subclinical thyroid dysfunction in patients with MDR-TB/HIV co-infection even, before the commencement of MDR-TB therapy.
已知结核分枝杆菌和人类免疫缺陷病毒(HIV)会导致甲状腺功能异常。关于HIV感染是否会加重耐多药结核病(MDR-TB)患者的甲状腺功能改变,相关信息较少。
本研究旨在确定HIV合并感染是否会改变MDR-TB患者的血清甲状腺激素(T3、T4)水平和促甲状腺激素(TSH)水平,并找出MDR-TB治疗开始前亚临床甲状腺功能障碍的发生率。
这项观察性横断面研究纳入了2010年7月至2014年12月期间在尼日利亚伊巴丹大学学院医院MDR-TB转诊中心新入院的所有患者。采用酶联免疫吸附测定法(ELISA)测定血清促甲状腺激素(TSH)、游离甲状腺素(fT4)和游离三碘甲状腺原氨酸(fT3)水平。
共纳入115例MDR-TB患者,其中22例(19.13%)合并MDR-TB/HIV感染。分别有5例(4.35%)、9例(7.83%)和2例(1.74%)患者出现病态甲状腺综合征(SES)、亚临床甲状腺功能减退和亚临床甲状腺功能亢进。与仅患MDR-TB的患者相比,合并MDR-TB/HIV感染的患者TSH中位数水平略高,而T3和T4中位数水平略低,但差异均无统计学意义。
从本研究可以得出结论,在开始MDR-TB药物治疗前,合并MDR-TB/HIV感染的患者与未感染HIV的MDR-TB患者甲状腺功能相似。此外,即使在开始MDR-TB治疗之前,合并MDR-TB/HIV感染的患者也有可能出现亚临床甲状腺功能障碍。