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Thyroid function in children with perinatal human immunodeficiency virus type 1 infection
F Chiarelli1, L Galli, A Verrotti
1Department of Medicine, University of Chieti, Italy. chiarelli@unich.it
Insights
Thyroid dysfunction is common in children with perinatal HIV-1 infection, with abnormalities appearing early and worsening with severe immunosuppression and high viral load. These thyroid changes precede clinical decline.
Area of Science:
- Pediatric Endocrinology
- Infectious Diseases
- Virology
Background:
- Perinatal human immunodeficiency virus type 1 (HIV-1) infection can impact multiple organ systems.
- Thyroid function is crucial for growth and development in children.
Purpose of the Study:
- To investigate thyroid function in children with perinatal HIV-1 infection.
- To correlate thyroid abnormalities with clinical status, disease progression, and viral load.
Main Methods:
- Retrospective analysis of 56 children with perinatal HIV-1 infection and 53 healthy controls.
- Measurement of various thyroid hormones (TT4, FT4, TT3, FT3, rT3, TSH) and related proteins (TG, TBG).
- Evaluation of thyroid autoantibodies.
Main Results:
- Children with HIV-1 infection showed significantly reduced TT3, TT4, FT4, and TG, and increased rT3, TBG, and TSH compared to controls.
- Thyroid dysfunction correlated with severe immunosuppression and high viral load.
- Thyroid abnormalities were detected early and worsened over time, preceding clinical deterioration.
Conclusions:
- Thyroid dysfunction is an early finding in perinatal HIV-1 infection.
- The severity of thyroid abnormalities is linked to immunosuppression and viral load.
- Thyroid function modifications may serve as an early indicator of disease progression in HIV-1 infected children.
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.
Study Design And Setting:
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.
Conclusion:
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.