Adan Asma A, Ojuang Redemtor A, Nyanjom Steven G, Maina Edward K
Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.
Department of Medical Biochemistry, Maseno University, Maseno, Kenya.
Thyroid Res. 2025 Jun 10;18(1):24. doi: 10.1186/s13044-025-00240-z.
The incidence of thyroid dysfunction is high in HIV patients, contributing to the high mortality and morbidity associated with HIV.
This study focused on evaluating the prevalence of thyroid dysfunction and associated factors among people living with HIV (PLWH) attending Comprehensive care centre at Maua Methodist Hospital, Kenya.
Clinical and sociodemographic data of participants were collected including HIV viral loads, CD4 counts, HAART regimen and type, age, gender, marital and education status, and co-infection. Serum levels of thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) were assessed in all groups. Regression analysis and Pearson correlation were performed to assess thyroid dysfunction and associated factors.
The prevalence of thyroid dysfunction was 51.9% (95% CI: 50.8 ~ 53.2) in this population. 77% (77%) of the HAART group had thyroid dysfunction compared to 47% of the HAART naïve group. Additionally, the prevalence of thyroid dysfunction was high in the HIV-non-suppressed individuals (97%, 95% CI: 97.1 ~ 97.9) compared to suppressed group (83%, 95% CI: 82.7 ~ 84.3). HIV (p < 0.001), HAART exposure (p < 0.001), TB (p < 0.001) and duration of infection (p = 0.002) were significantly associated with thyroid dysfunction. There was a positive correlation between TSH (r = 0.28; p < 0.01) and HIV + individuals under HAART, TSH (r = 0.37; p < 0.001) and TB, and FT3 (r = 0.35; p < 0.001) and duration of infection. Additionally, there was positive corelation between thyroid dysfunction and age (r = 0.13, p = 0.13), and a negative correlation between thyroid dysfunction and CD4 counts (r = -0.39, p < 0.055) though statistically not significant.
Thyroid dysfunction is more common in HIV patients on HAART, mainly manifested as subclinical hypothyroidism. Routine screening for thyroid dysfunction should be considered for PLWH, especially those on HAART and with viral blips.
甲状腺功能障碍在HIV患者中发病率较高，这导致了与HIV相关的高死亡率和高发病率。
本研究聚焦于评估肯尼亚毛阿卫理公会医院综合护理中心接受治疗的HIV感染者（PLWH）中甲状腺功能障碍的患病率及相关因素。
收集参与者的临床和社会人口统计学数据，包括HIV病毒载量、CD4细胞计数、HAART治疗方案及类型、年龄、性别、婚姻和教育状况以及合并感染情况。对所有组进行血清促甲状腺激素（TSH）、游离甲状腺素（FT4）和游离三碘甲状腺原氨酸（FT3）水平评估。进行回归分析和Pearson相关性分析以评估甲状腺功能障碍及相关因素。
该人群中甲状腺功能障碍的患病率为51.9%（95%可信区间：50.8～53.2）。接受HAART治疗的组中有77%存在甲状腺功能障碍，而未接受HAART治疗的组中这一比例为47%。此外，HIV病毒未被抑制的个体中甲状腺功能障碍的患病率较高（97%，95%可信区间：97.1～97.9），相比之下病毒被抑制的组患病率为83%（95%可信区间：82.7～84.3）。HIV（p<0.001）、HAART治疗暴露（p<0.001）、结核病（p<0.001）和感染持续时间（p = 0.002）与甲状腺功能障碍显著相关。在接受HAART治疗的HIV阳性个体中，TSH（r = 0.28；p<0.01）与之呈正相关，TSH（r = 0.37；p<0.001）与结核病呈正相关，FT3（r = 0.35；p<0.001）与感染持续时间呈正相关。此外，甲状腺功能障碍与年龄呈正相关（r = 0.13，p = 0.13），与CD4细胞计数呈负相关（r = -0.39，p<0.055），不过在统计学上不显著。
接受HAART治疗的HIV患者中甲状腺功能障碍更为常见，主要表现为亚临床甲状腺功能减退。应考虑对PLWH进行甲状腺功能障碍的常规筛查，尤其是那些接受HAART治疗且出现病毒波动的患者。
