Thyroid dysfunction in human immunodeficiency virus-infected children and its correlation with CD4(+) T lymphocyte count

CONTEXT: Thyroid dysfunction has been reported in human immunodeficiency virus (HIV)-infected individuals including children. Some studies have reported that thyroid dysfunction may be a marker of severity or progression of HIV. AIMS: The aim was to study thyroid function in HIV-infected children with and without highly active anti-retroviral therapy (HAART). SETTINGS AND DESIGN: Cross-sectional study carried out at a teaching hospital with Anti-Retroviral Therapy Centre (Centre of Excellence) of National AIDS Control Organization. SUBJECTS AND METHODS: Thyroid stimulating hormone (TSH), total thyroxine (T4), and total tri-iodothyronine (T3) were analyzed in 60 pediatric HIV cases: 30 on HAART and 30 HAART naive. Correlation of T3, T4, and TSH with CD4 count was assessed. STATISTICAL ANALYSIS USED: Data reported as mean ± standard deviation and as the number of cases and percentages. Comparison between groups was done by independent sample t-test and χ(2)-test. Spearman's correlation coefficient is used to assess the association between thyroid dysfunction and CD4 count. RESULTS: Thyroid function abnormality was seen in five out of 30 patients in both patients on HAART or without HAART therapy. Among patients on HAART, three had hypothyroidism, and two had biochemical feature of sick euthyroid syndrome. Among the HAART naive group, sub-clinical hypothyroisim was seen in four, and one had biochemical feature of sick euthyroid syndrome. None of the patients had clinical features of thyroid dysfunction. There is a highly significant correlation (P = 0.01) between TSH and CD4 count. CONCLUSIONS: Thyroid dysfunction is quite common among pediatric HIV cases. An inverse correlation is seen between TSH and CD4 count indicating trend for hypothyroidism as HIV disease progress.