A Clinical Study of Thyroid Abnormalities in HIV Infected Patients attending OPD in Government Mohan Kumaramangalam Medical College Hospital, Salem

Nithya Priya, P (2020) A Clinical Study of Thyroid Abnormalities in HIV Infected Patients attending OPD in Government Mohan Kumaramangalam Medical College Hospital, Salem. Masters thesis, Government Mohan Kumaramangalam Medical College, Salem.


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INTRODUCTION: Abnormal thyroid function test results are common in human immunodeficiency virus infected patients. Among indvidvuals infected with HIV, 1-2% experience overt thyroid illness and 35% have subtle abnormalities in thyroid function tests. In persons with advanced HIV disease a variety of systemic infections infiltrate thyroid gland resulting in either increase or decrease in thyroid hormones. Cases of thyroiditis have been also reported. In addition lymphomas and Kaposi’s sarcoma also infiltrate and impair thyroid function. The widespread use of antiretroviral therapy has led to decline in incidence of glandular infiltration by infections and neoplasms. Some medications used to treat HIV infection can also induce thyroid dysfunction. It can also be explained by hormonal changes as a stress response to comorbidities or advanced disease state, & as a component of immune reconstitution syndrome. Sub clinical hypothyroidism is the most prevalent thyroid abnormality and it is a precursor for overt hypothyroidism. Hence thyroid abnormalities may contribute o morbidity of patients having a bearing on quality of life of HIV infected patients. The high incidence of hypothyroidism may have importance in management of these patients. A routine screening for thyroid function may be advocated in patients with advanced immunosuppression. OBJECTIVES: 1. To study the prevalence of thyroid abnormalities in HIV infected persons. 2. To classify the spectrum of Thyroid illness. MATERIALS AND METHODS: STUDY POPULATION: This study is conducted among 75 seropositive HIV patients attending medicine and ART outpatient department in Government Mohan Kumaramangalam Medical College Hospital, Salem. For these patients T3, T4, TSH, CD4 counts are done and results are analyzed. RESULTS: Of the 75 patients, mean age was 39 years and 37 are females. Of thyroid dysfunction 46.7% Euthyroid, and 38.7% have subclinical hypothyroidism 41.3%. Has a high TSH > 5 micro IU/L. Incidence of subclinical hypothyroidism been equal in males and females. Statistically significant association was found between CD4 and TSH (p value 0.006) and BMI and CD4 (p value 0.046). CONCLUSIONS: Most common thyroid dysfunction observed in HIV infected patients is subclinical hypothyroidism followed by hypothyroidism. Thyroid dysfunction has significant association with HIV infection, and more common with lowering CD4 counts. As the disease advances incidence and prevalence of thyroid dysfunction also increases. Hypothyroidism significantly impairs the quality of life in HIV infected patients. Hence thyroid function test as a part of screening with advanced disease may be done on routine basis.

Item Type: Thesis (Masters)
Additional Information: 201711405
Uncontrolled Keywords: HIV, Thyroid function test, Subclinical hypothyroidism, CD4 count.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 28 Jan 2021 18:48
Last Modified: 31 Jan 2021 02:28
URI: http://repository-tnmgrmu.ac.in/id/eprint/13338

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