Viro-immunology Research Unit and Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Copenhagen.
Department of Infectious Diseases, Hvidovre Hospital, University of Copenhagen, Hvidovre.
AIDS. 2018 Sep 24;32(15):2195-2199. doi: 10.1097/QAD.0000000000001954.
Possible effects of HIV on thyroid function in the modern combination antiretroviral therapy (cART) era are largely unknown. We aimed to investigate the prevalence and associated risk factors of thyroid dysfunction in well treated people living with HIV (PLWH) and matched uninfected controls and to examine whether HIV is independently associated with thyroid dysfunction.
Thyroid-stimulating hormone (TSH), free thyroxine, total thyroxine, and free triiodothyronine were measured in 826 PLWH from the Copenhagen co-morbidity in HIV infection (COCOMO) Study and in 2503 matched uninfected controls, and medical treatment for hypothyroidism or hyperthyroidism was recorded. Multinomial logistic regression adjusting for known risk factor was used to examine the association between HIV and thyroid dysfunction and multivariate linear regression to study the association between HIV and serum TSH concentrations.
The PLWH were generally well treated, with 95% having undetectable viral replication. Among PLWH and controls 31 (3.8%) and 114 (4.6%) had hypothyroidism, and 7 (0.8%) and 21 (0.8%) had hyperthyroidism, respectively. In adjusted analyses, we found no significant associations between HIV and hypothyroidism OR 0.8 [95% confidence interval (CI) 0.6-1.3], P = 0.40 or between HIV and hyperthyroidism OR 1.1 (95% CI 0.5-2.5), P = 0.91. Furthermore, serum TSH concentration was unrelated to HIV status (P = 0.6).
There was no difference in the prevalence of hyperthyroidism or hypothyroidism in well treated PLWH compared with uninfected controls. HIV status was not associated with thyroid dysfunction or serum TSH concentration.
在现代联合抗逆转录病毒疗法（cART）时代，HIV 对甲状腺功能的可能影响在很大程度上尚不清楚。我们旨在调查治疗良好的 HIV 感染者（PLWH）和匹配的未感染者中甲状腺功能障碍的患病率和相关危险因素，并研究 HIV 是否与甲状腺功能障碍独立相关。
在哥本哈根 HIV 感染合并症研究（COCOMO）中，对 826 名 PLWH 和 2503 名匹配的未感染者测量了促甲状腺激素（TSH）、游离甲状腺素、总甲状腺素和游离三碘甲状腺原氨酸，并记录了甲状腺功能减退或甲状腺功能亢进的药物治疗情况。采用调整已知危险因素的多项逻辑回归来检查 HIV 与甲状腺功能障碍之间的关联，采用多元线性回归来研究 HIV 与血清 TSH 浓度之间的关联。
PLWH 的治疗通常效果良好，95%的患者病毒复制无法检测到。在 PLWH 和对照组中，分别有 31 例（3.8%）和 114 例（4.6%）患有甲状腺功能减退症，7 例（0.8%）和 21 例（0.8%）患有甲状腺功能亢进症。在调整后的分析中，我们发现 HIV 与甲状腺功能减退症之间无显著关联（OR 0.8，95%可信区间 0.6-1.3，P=0.40），或与甲状腺功能亢进症之间无显著关联（OR 1.1，95%可信区间 0.5-2.5，P=0.91）。此外，血清 TSH 浓度与 HIV 状态无关（P=0.6）。
与未感染者相比，治疗良好的 PLWH 中甲状腺功能亢进症或甲状腺功能减退症的患病率无差异。HIV 状态与甲状腺功能障碍或血清 TSH 浓度无关。
