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Association between antiretrovirals and thyroid diseases: a cross-sectional study
Guilherme Almeida Rosa da Silva1, Mayra Christina Teixeira Andrade1, Daniel de Alvarenga Salém Sugui1
1Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Archives of Endocrinology and Metabolism
|May 21, 2015
Summary
This study found a high prevalence of thyroid disease in HIV patients. Stavudine use increased the risk of subclinical hypothyroidism, while immune reconstitution showed a protective trend against thyroid disease.
Area of Science:
- Endocrinology
- Infectious Diseases
- Immunology
Background:
- Thyroid diseases are common in HIV-infected individuals.
- Antiretroviral therapy (ART) can impact immune function and potentially thyroid health.
- Understanding these associations is crucial for managing HIV patients.
Purpose of the Study:
- To determine the prevalence of thyroid diseases and anti-TPO antibodies in HIV patients.
- To investigate the association between immune reconstitution and ART (stavudine, didanosine, protease inhibitors) with thyroid diseases.
Main Methods:
- A cross-sectional study analyzed records of 117 HIV-infected patients.
- Data included CD4+ cell count, viral load, anti-TPO, TSH, and free T4 levels.
- Immune reconstitution was defined by CD4+ count changes post-ART; statistical analysis used odds ratios and chi-square tests.
Main Results:
- Thyroid disease prevalence was 34.18%, with 4.34% positive for anti-TPO.
- Stavudine use was significantly associated with an increased risk of subclinical hypothyroidism (OR = 4.19, p = 0.01).
- Immune reconstitution showed a trend towards protection against thyroid disease (OR = 0.45, p = 0.059).
Conclusions:
- The prevalence of thyroid disease in this HIV cohort exceeds literature reports, with low anti-TPO positivity.
- Historical stavudine use is a risk factor for subclinical hypothyroidism.
- Immune reconstitution appears to offer a protective effect against thyroid diseases in HIV patients.
