title: Association between antiretrovirals and thyroid diseases: a cross-sectional study.
abstract: OBJECTIVE
  This study aims to estimate the prevalence of thyroid diseases and anti-TPO status. We searched for an association among presence of immune reconstitution and use of stavudine, didanosine and protease inhibitors with thyroid diseases.
  
  
  METHODS
  A cross-sectional study was performed to analyze the records of 117 HIV-infected patients who had their CD4+ cell count, viral load, anti-TPO, TSH and free T4 levels collected on the same day. Immune reconstitution was considered in those whose T CD4+ count was below 200 cells/mm3, but these values increased above 200 cells/mm3 after the use of antiretrovirals. The odds ratio obtained by a 2x2 contingency table and a chi-square test were used to measure the association between categorical variables.
  
  
  RESULTS
  The prevalence of thyroid disease was 34.18%; of these, 4.34% were positive for anti-TPO. There was an association of risk between stavudine use and subclinical hypothyroidism (OR = 4.19, 95% CI: 1.29 to 13.59, X2 = 6.37, p = 0.01). Immune reconstitution achieved protection associated with thyroid disease that was near statistical significance OR = 0.45, 95% CI: 0.19 to 1.04, X2 = 3.55, p = 0.059.
  
  
  CONCLUSIONS
  The prevalence of thyroid disease in the sample studied was higher than what had been found in the literature, with a low positive anti-TPO frequency. The historical use of stavudine has an association of risk for the presence of subclinical hypothyroidism, and immune reconstitution has trends towards protection for the presence of thyroid diseases.
authors.affiliation: Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Guilherme Almeida Rosa da
authors.initials: GA
authors.lastname: Silva
authors.affiliation: Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Mayra Christina Teixeira
authors.initials: MC
authors.lastname: Andrade
authors.affiliation: Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Daniel de Alvarenga Salém
authors.initials: Dde A
authors.lastname: Sugui
authors.affiliation: Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Rafael Fernandes
authors.initials: RF
authors.lastname: Nunes
authors.affiliation: Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Jorge Francisco da Cunha
authors.initials: JF
authors.lastname: Pinto
authors.affiliation: Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Walter de Araujo
authors.initials: WA
authors.lastname: Eyer Silva
authors.affiliation: Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Fernando Raphael de Almeida
authors.initials: FR
authors.lastname: Ferry
authors.affiliation: Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Marcelo Costa Velho Mendes de
authors.initials: MC
authors.lastname: Azevedo
authors.affiliation: Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Rogerio Neves
authors.initials: RN
authors.lastname: Motta
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D058070:Asymptomatic Diseases / Q000453:epidemiology / Q000628:therapy; D001323:Autoantibodies / Q000302:isolation & purification*; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D016049:Didanosine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000139:chemically induced / Q000453:epidemiology* / Q000276:immunology; D007453:Iodide Peroxidase / Q000276:immunology*; D008297:Male; D015995:Prevalence; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D018119:Stavudine / Q000009:adverse effects / Q000627:therapeutic use*; D013959:Thyroid Diseases / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D044966:Anti-Retroviral Agents; D001323:Autoantibodies; D018894:Reverse Transcriptase Inhibitors; D018119:Stavudine; D007453:Iodide Peroxidase; D016049:Didanosine