title: Unique alterations of thyroid hormone indices in the acquired immunodeficiency syndrome (AIDS)
abstract: 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.
authors.affiliation: University of Southern California School of Medicine, Los Angeles.
authors.forename: J S
authors.initials: JS
authors.lastname: LoPresti
authors.forename: J C
authors.initials: JC
authors.lastname: Fried
authors.forename: C A
authors.initials: CA
authors.lastname: Spencer
authors.forename: J T
authors.initials: JT
authors.lastname: Nicoloff
mesh_terms: 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
chemical_list: D013963:Thyroid Hormones