Unique alterations of thyroid hormone indices in the acquired immunodeficiency syndrome (AIDS)
OBJECTIVE
To determine alterations in serum thyroid hormone indices in patients with human immunodeficiency virus (HIV) infection.


METHODS
Prospective, single-blind study.


METHODS
Large metropolitan hospital where 20% of all patients with the acquired immunodeficiency syndrome (AIDS) in Los Angeles are treated.


METHODS
Twenty-six inpatients with bronchoscopy-proven Pneumocystis carinii pneumonia and AIDS. Outpatients included 10 persons seropositive for HIV, 10 with AIDS-related complex, and 10 with AIDS.


RESULTS
There were 19 survivors and 7 nonsurvivors of P. carinii infection. Serum triiodothyronine (T3) values generally remained normal until hospitalization, with nonsurvivors having lower values than survivors (0.56 +/- 0.1 nmol/L compared with 1.3 +/- 0.1 nmol/L, P less than 0.002, respectively). Reverse triiodothyronine (rT3) levels were low in persons with AIDS-related complex (0.21 +/- 0.02 nmol/L, P less than 0.001) and in AIDS outpatients (0.17 +/- 0.02 nmol/L, P less than 0.001). Normalization of rT3 occurred after patients were hospitalized (0.28 +/- 0.01 nmol/L). Serum thyroxine-binding globulin values rose with progression of HIV infection (seropositive, 369.7 +/- 18.1 nmol/L, P less than 0.005; AIDS-related complex, 419.1 +/- 37.0 nmol/L, P less than 0.005; AIDS, 423.3 +/- 31.9 nmol/L, P less than 0.005; survivors, 476.3 +/- 24.6 nmol/L, P less than 0.001), whereas nonsurvivors had normal values. All values are compared with normal values (T3, 2.3 +/- 0.04 nmol/L; rT3, 0.28 +/- 0.01 nmol/L; thyroxine-binding globulin, 288.2 +/- 6.9 nmol/L).


CONCLUSIONS
Infection with HIV produces unique alterations in thyroid function. A progressive decline in rT3 and elevation in thyroxine-binding globulin accompany advancing HIV infection. The persistence of a normal T3 despite progression of HIV infection may contribute to weight loss. A low serum T3 on admission correlates with mortality.
LoPresti
J S
JS
University of Southern California School of Medicine, Los Angeles.
Fried
J C
JC
Spencer
C A
CA
Nicoloff
J T
JT
D000386:AIDS-Related Complex / Q000097:blood; D000163:Acquired Immunodeficiency Syndrome / Q000097:blood* / Q000401:mortality; D015496:CD4-Positive T-Lymphocytes; D003422:Critical Care; D006679:HIV Seropositivity / Q000097:blood; D006801:Humans; D007958:Leukocyte Count; D011020:Pneumonia, Pneumocystis / Q000097:blood; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D013963:Thyroid Hormones / Q000097:blood*; D015431:Weight Loss
D013963:Thyroid Hormones