Subclinical hypothyroidism in HIV-infected subjects.
OBJECTIVE
The correlation between subclinical hypothyroidism [thyroid stimulating hormone (TSH)>4 mIU/L with normal free triiodothyroxine and free thyroxine levels], HIV infection and HAART is still unclear.


METHODS
To evaluate the predictive factors of subclinical hypothyroidism in an HIV-infected population, we identified three groups of subjects: G1, subjects on stable highly active antiretroviral therapy (HAART) (for at least 1 year) at baseline and at month 24 (n=97); G2, subjects naive at both baseline and month 24 (n=47); G3, subjects starting HAART at baseline (n=46).


RESULTS
The three groups were comparable with respect to age, gender, body weight and prevalence of HCV infection. At baseline, subclinical hypothyroidism was detected in 14 subjects in G1 (14.4%), 5 in G2 (10.6%) and 4 in G3 (8.7%) (P=0.18) and these were excluded from the analysis. At month 24, 15 subjects had developed subclinical hypothyroidism: 4 in G1 (4.8%), 3 in G2 (7.1%) and 8 in G3 (19.0%). In the multivariable analysis, the higher increase in total cholesterol was predictive of subclinical hypothyroidism (RR: 1.53 for each additional 10 mg/dL, 95% CI 1.23-1.90; P<0.01); other variables, which were statistically significant in the univariate analysis, such as G3 group, body weight and higher increase in CD4+ cell count and in triglyceride serum levels were not confirmed to be associated with TSH alterations.


CONCLUSIONS
The occurrence of subclinical hypothyroidism in HIV-positive patients seems to be related to the increase in total cholesterol serum levels occurring after HAART initiation. Thyroid function should be monitored in all HIV-infected subjects, especially in those starting HAART.
Bongiovanni
Marco
M
Clinic of Infectious Diseases, San Paolo Hospital, University of Milan, Milan, Italy. marco.bongiovanni@unimi.it
Adorni
Fulvio
F
Casana
Maddalena
M
Tordato
Federica
F
Tincati
Camilla
C
Cicconi
Paola
P
Bini
Teresa
T
d'Arminio Monforte
Antonella
A
D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D005260:Female; D006678:HIV / Q000302:isolation & purification*; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000139:chemically induced / Q000209:etiology* / Q000821:virology; D008297:Male; D008875:Middle Aged