Effect of Antiretroviral Therapy to Thyroid Function Status on New Stage 1 and 2 Human Immunodeficiency Virus Patient
DOI:
https://doi.org/10.3889/oamjms.2023.11511Keywords:
Human immunodeficiency virus, Antiretroviral therapy, Thyroid function testAbstract
Background: Thyroid hormone is very important in regulating energy metabolism in all tissues of the human body. Thyroid dysfunction plays an important role in osteoporosis, hyperlipidemia and cardiovascular disease, all of which are associated with Human Immunodeficiency Virus (HIV) infection or therapy for HIV. Medications used to treat HIV infection are also said to be important factors that can cause thyroid abnormalities. This study aim is to see the effect of giving Antiretroviral Therapy (ART) to the thyroid function of new HIV patients in stage 1 and 2.
Method: This prospective cohort study was conducted at Medan city health center and Medan Haji Adam Malik Hospital in March-June 2019. HIV patients who met the inclusion criteria were tested for thyroid function (Ft4 and TSH) before and after 3 months on ART, BMI, routine blood, CD4 and quality of life using the SF-36 questionnaire. Data analysis used paired t test and Pearson correlation.
Result: 34 patients with stage 1 and 2 HIV showed normal thyroid function ; the average FT4 level was 1.03 ± 0.14 ng / dl and the average TSH level was 1.44 ± 0.68 µIU / mL. After 3 months of antiretroviral therapy, the mean thyroid function changes were obtained from the study subjects, where the mean FT4 results were 0.87 ± 0.13 ng / dl and the average TSH results were 1.76 ± 0.91 µIU / mL and the results were statistically significant with p 0.006 (p <0.05). There was a statistically significant relationship between TSH and CD4 levels with BMI after ART administration (p <0.05), but no statistically significant relationship was found between FT4 and BMI (p = 0.957). No statistically significant relationship was found between CD4 levels in study subjects and changes in fT4 levels (p = 0.557, r = 0.104) and TSH (p = 0.267, r = 0.196). There was also no significant difference in the quality of life of study subjects as seen from the SF-36 questionnaire both from changes in thyroid function and from CD4 levels.
Conclusion: Stage 1 and 2 HIV patients who are on ART for 3 months experienced thyroid dysfunction.
Downloads
Metrics
Plum Analytics Artifact Widget Block
References
Yen PM. Physiological and molecular basis of thyroid hormone action. Physiol Rev. 2001;81(3):1097-142. https://doi.org/10.1152/physrev.2001.81.3.1097 PMid:11427693 DOI: https://doi.org/10.1152/physrev.2001.81.3.1097
Klecha AJ, Genaro AM, Lysionek AE, Caro RA, Coluccia AG, Cremaschi GA, et al. Experimental evidence pointing to the bidirectional interaction between the immune system and the thyroid axis. Int J Immunopharmacol. 2000;22(7):491-500. https://doi.org/10.1016/s0192-0561(00)00012-6 PMid:10785546 DOI: https://doi.org/10.1016/S0192-0561(00)00012-6
Klecha AJ, Genaro AM, Gorelik G, Arcos ML, Silberman DM, Schuman M, et al. Integrative study of hypothalamus-pituitary-thyroid-immune system interaction: Thyroid hormone-mediated modulation of lymphocyte activity through the protein kinase C signaling pathway. J Endocrinol. 2006;189(1):45-55. https://doi.org/10.1677/joe.1.06137 PMid:16614380 DOI: https://doi.org/10.1677/joe.1.06137
Arnsten JH, Freeman R, Howard AA, Floris-Moore M, Lo Y, Klein RS, et al. Decreased bone mineral density and increased fracture risk in aging men with or at risk for HIV infection. AIDS. 2007;21(5):617-23. https://doi.org/10.1097/QAD.0b013e3280148c05 PMid:17314524 DOI: https://doi.org/10.1097/QAD.0b013e3280148c05
Madeddu G, Spanu A, Chessa F, Calia GM, Lovigu C, Solinas P, et al. Thyroid function in human immunodeficiency virus patients treated with highly active antiretroviral therapy (HAART): A longitudinal study. Clin Endocrinol (Oxf). 2006;64(4):375-83. https://doi.org/10.1111/j.1365-2265.2006.02472.x PMid:16584508
Harslof M, Knudsen AD, Benfield T. No evidence of increased risk of thyroid dysfunction in well treated people living with HIV. AIDS. 2018;32(15):2195-9. https://doi.org/10.1097/QAD.0000000000001954 PMid:30005023 DOI: https://doi.org/10.1097/QAD.0000000000001954
Santisteban P. Development of the hypothalamic-pituitary-thyroid axis. In: Braverman LE, Cooper DS, editors. Thyroid a Fundamental and Clinical Text. 10th ed. United States: Lippincott Williams and Wilkins; 2013.
Nelson M, Powles T, Zeitlin A, Sen P, Scourfield A, Bower M, et al. Thyroid dysfunction and relationship to antiretroviral therapy in HIV-positive individuals in the HAART era. J Acquir Immune Defic Syndr. 2009;50(1):113-4. https://doi.org/10.1097/QAI.0b013e31818ce835 PMid:19092451 DOI: https://doi.org/10.1097/QAI.0b013e31818ce835
Noureldeen AF, Qusti SY, Khoja GM. Thyroid function in newly diagnosed HIV-infected patients. Toxycol Ind Health. 2012;30(10):919-25. https://doi.org/10.1177/0748233712466133 PMid:23188649 DOI: https://doi.org/10.1177/0748233712466133
Madge S, Smith CJ, Lampe FC, Thomas M, Johnson MA, Youle M, et al. No association between HIV disease and its treatment and thyroid function. HIV Med. 2007;8(1):22-7. https://doi.org/10.1111/j.1468-1293.2007.00422.x PMid:17305928 DOI: https://doi.org/10.1111/j.1468-1293.2007.00422.x
Madeddu G, Spanu A, Chessa F, Calia GM, Lovigu C, Solinas P, et al. Thyroid function in human immunodeficiency virus patients treated with highly active antiretroviral therapy (HAART): A longitudinal study. Clin Endocrinol (Oxf). 2006;64(4):375-83. https://doi.org/10.1111/j.1365-2265.2006.02472.x PMid:16584508 DOI: https://doi.org/10.1111/j.1365-2265.2006.02472.x
Ricart-Engel W, Fernandez-Real JM, Gonzalez-Huix F, Del Pozo M, Mascaro J, Garcia-Bragado F. The relation between thyroid function and nutritional status in HIV-infected patients. Clin Endocrinol (Oxf). 1996;42(1):1270-6. https://doi.org/10.1046/j.1365-2265.1996.623445.x PMid:8706293 DOI: https://doi.org/10.1046/j.1365-2265.1996.623445.x
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2023 Melati Silvanni Nasution, Dharma Lindarto, Tambar Kembaren (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
http://creativecommons.org/licenses/by-nc/4.0
