ORIGINAL ARTICLE |
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Year : 2013 | Volume
: 1
| Issue : 1 | Page : 20-24 |
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An observational study of endocrine disorders in HIV infected patients from north India
Nirdesh Jain, Madhukar Mittal, Himanshu Dandu, Shailendra P Verma, Manish Gutch, Anil K Tripathi
Department of Internal Medicine, King George’s Medical University, Lucknow, Uttar Pradesh, India
Correspondence Address:
Nirdesh Jain Room no. E/206, Gautam Buddha Hostel, King George Medical University, Lucknow - 226 003, Uttar Pradesh India
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Objective: Human immunodeficiency virus (HIV) infection is known to affect every organ system of the body, either directly or through opportunistic infections. Ours was a cross-sectional study to determine the prevalence of thyroid, adrenal, and gonadal dysfunction in HIV patients and to correlate these with stages of HIV infection, antiretroviral therapy, and with the associated wasting. Design: HIV patients aged ≥15 years were enrolled from July 2009 to June 2010. Each enrolled patient underwent through a thorough clinical evaluation, and questionnaire specifying the endocrine disorders were asked specifically to them. Thyroid function test (T3, T4, and TSH), serum cortisol, serum testosterone, LH, and FSH at 8:00 AM were estimated. Results: A total of 117 (90 males, 27 females) patients with a mean age of 34.10 ± 8.3 years were enrolled. TSH was elevated in 9% from reference cut-off value of 0.25-5.5 mIU/L. Only 2% were overtly hypothyroid because they had symptoms and TSH was >10 mIU/L in them. Serum cortisol could be estimated in 97 patients, of them 5 had definitive adrenal insufficiency (AI) (serum cortisol <100 nmol/l), 54 were indeterminate (100-500 nmol/l), and 38 were excluded for AI (>500 nmol/l). No patient had hypotension. Hypogonadism (serum testosterone <200 ng/dl) was found in 75.7% (28/37) males patients. However, only 27% (10/37) patients complained of impotency. The wasting was evident in 61.53% of the total patients and had positive correlation with only testosterone levels in males (P = 0.864). Conclusions: Hypothyroidism seen in HIV patients was predominantly subclinical. Since we excluded seriously ill patients from the study, sick euthyroid syndrome is unlikely as a cause for the abnormal thyroid function tests. Decreased levels of serum cortisol were found although with unclear clinical significance. HIV infected males had hypogonadism, probably hypogonadotropic. |
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