Thyroid function in children with perinatal human immunodeficiency virus type 1 infection.
OBJECTIVE
To study thyroid function in children with perinatal HIV-1 infection retrospectively and determine whether thyroid abnormalities are correlated with clinical condition, disease progression, immunological impairment, and viral load.


METHODS
Total (TT4) and free (FT4) thyroxine, total (TT3) and free (FT3) triiodothyronine, reverse triiodothyronine (rT3), thyrotropin (TSH), thyroglobulin (TG), and thyroid binding globulin (TBG) were measured twice in 56 children with perinatal human immunodeficiency virus type 1 (HIV-1) infection. Median age at first determination was 13.5 (range: 0.03-127.0) months; median age at second determination was 66.2 (range 3.42-147.4) months. Antithyroglobulin, antimicrosomal, thyroid peroxidase, and thyrotropin receptor antibodies were also evaluated. Fifty-three healthy children were selected as controls.


RESULTS
TT3, TT4, FT4, and TG were significantly reduced and rT3, TBG, and TSH increased in children with HIV-1 infection when compared with controls. Thyroid dysfunction correlated with severe immunosuppression and high viral load early in life preceded the onset of the disease and worsened over time. Autoantibodies were negative in all children with HIV-1 infection in all determinations.


CONCLUSIONS
Thyroid abnormalities are observed early in the course of perinatal HIV-1 infection; thyroid dysfunction is particularly pronounced in children with severe immunosuppression and high viral load. Modifications of thyroid function precede worsening of clinical course in HIV-1 infected children.
Chiarelli
F
F
Department of Medicine, University of Chieti, Italy. chiarelli@unich.it
Galli
L
L
Verrotti
A
A
di Ricco
L
L
Vierucci
A
A
de Martino
M
M
D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000276:immunology / Q000503:physiopathology* / Q000821:virology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000276:immunology / Q000503:physiopathology* / Q000821:virology; D008297:Male; D012367:RNA, Viral / Q000096:biosynthesis / Q000235:genetics; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000276:immunology / Q000503:physiopathology* / Q000821:virology
D012367:RNA, Viral