HIV Infections Clinical Trial
Official title:
Prevalence of Thyroid Function Abnormalities in HIV-infected Patients: State of Play in 2012
Review the evolution of thyroid function in HIV-infected patients, with sufficient follow-up.
Since the appearance of high-efficiency anti-retrovirals (HAARTs) in the treatment of Human
Immunodeficiency Virus (HIV), several studies have shown an increase in the prevalence of
hypothyroidism (frank, rough or low hypothyroidism T4) in cohorts of HIV-infected adults and
children. More specifically, rough hypothyroidism (increased TSH and normal thyroid
peripheral hormones) have a prevalence of about 3-12% in HIV-treated patients, which is
higher than the general population of about 4.3%. The etiology of frustrated hypothyroidism
remains debated in the literature; Effects of antiretroviral therapy (ARV) such as
Stavudine®, the effect of dyslipidemia, the effect of HIV infection itself, in proportion to
severity (expressed as low CD4 cell count) and AIDS stage. Thyroid dysfunction does not
appear to be of autoimmune origin, as anti-peroxidase antibodies are rarely present in
HIV-infected patients, unlike the general population.
With the increased life expectancy of HIV-infected patients and the indications of different
experts to be treated earlier, the duration of exposure to ARVs is also increasing.
Therefore, their chronic toxicity deserves particular attention, in particular on thyroid
function and / or thyroid hormone metabolism, since iatrogenicity has not been completely
ruled out. In addition, clinical evidence suggests that dysthyroids may be corrected or
worsened over time in HIV patients (unpublished personal data).
Today, the natural history of frustrated hypothyroidism and its consequences are not reported
in patients infected with HIV. However, it is recognized in the elderly, fructified
hypothyroidism evolves over time towards frank hypothyroidism; The latter is associated with
an increased prevalence of dyslipidemia, atherosclerosis, diastolic hypertension and
therefore an increased risk of myocardial infarction.
It therefore seems interesting to review the evolution of thyroid function in HIV-infected
patients, with sufficient follow-up.
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