Thyroid dysfunction in human immunodeficiency virus-infected children and its correlation with CD4(+) T lymphocyte count.
BACKGROUND
Thyroid dysfunction has been reported in human immunodeficiency virus (HIV)-infected individuals including children. Some studies have reported that thyroid dysfunction may be a marker of severity or progression of HIV.


OBJECTIVE
The aim was to study thyroid function in HIV-infected children with and without highly active anti-retroviral therapy (HAART).


METHODS
Cross-sectional study carried out at a teaching hospital with Anti-Retroviral Therapy Centre (Centre of Excellence) of National AIDS Control Organization.


METHODS
Thyroid stimulating hormone (TSH), total thyroxine (T4), and total tri-iodothyronine (T3) were analyzed in 60 pediatric HIV cases: 30 on HAART and 30 HAART naive. Correlation of T3, T4, and TSH with CD4 count was assessed.


METHODS
Data reported as mean ± standard deviation and as the number of cases and percentages. Comparison between groups was done by independent sample t-test and χ(2)-test. Spearman's correlation coefficient is used to assess the association between thyroid dysfunction and CD4 count.


RESULTS
Thyroid function abnormality was seen in five out of 30 patients in both patients on HAART or without HAART therapy. Among patients on HAART, three had hypothyroidism, and two had biochemical feature of sick euthyroid syndrome. Among the HAART naive group, sub-clinical hypothyroisim was seen in four, and one had biochemical feature of sick euthyroid syndrome. None of the patients had clinical features of thyroid dysfunction. There is a highly significant correlation (P = 0.01) between TSH and CD4 count.


CONCLUSIONS
Thyroid dysfunction is quite common among pediatric HIV cases. An inverse correlation is seen between TSH and CD4 count indicating trend for hypothyroidism as HIV disease progress.
Department of Paediatrics, Regional Institute of Medical Sciences, Imphal, Manipur, India.
Satyakumar
S
Thongam
Department of Paediatrics, Regional Institute of Medical Sciences, Imphal, Manipur, India.
Sunibala
S
Keithelakpam
Department of Paediatrics, Regional Institute of Medical Sciences, Imphal, Manipur, India.
Tomba Y
TY
Singh
Department of Paediatrics, Regional Institute of Medical Sciences, Imphal, Manipur, India.
Ranbir L
RL
Singh
Department of Biochemistry, Regional Institute of Medical Sciences, Imphal, Manipur, India.
Amuba M
AM
Singh
Department of Medicine, Regional Institute of Medical Sciences, Imphal, Manipur, India.
Salam
S
Ranabir
Highly active anti-retroviral therapy; hypothyroidism; sick-euthyroid; sub-clinical hypothyroidism