Thyroid disorders in patients with human immunodeficiency virus infection: a meta-analysis

Abstract

BACKGROUND: Thyroid disorders have significant clinical sequelae, including impaired growth in children, metabolic abnormalities, and impaired cognitive function. However, available studies on burden of thyroid diseases in people with human immunodeficiency virus (HIV), particularly its prevalence and its interaction with HIV related factors (like CD4 count), are controversial. This review aimed to provide a comprehensive summary and analysis on the extent of thyroid dysfunctions in this population. METHODS: Following Preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines, a comprehensive search was done through Medline/PubMed, Web of Science, Science Direct, and World Health Organization Virtual Health Library Regional Portal. Using Comprehensive Meta-Analysis Software version 3.3, we calculated the pooled prevalence and standardized mean difference (SMD) estimates with 95% confidence intervals (CIs). RESULTS: A total of 30 studies met the eligibility criteria and were further included for the analyses. The most common types of thyroid dysfunction identified among HIV patients were subclinical hypothyroidism (7.7%), overt hypothyroidism (2.7%), sick euthyroid syndrome (2.47%), isolated low FT4 (1.80%), and overt hyperthyroidism (0.7%). Hypothyroidism among HIV patients was significantly associated with lower CD4 count (p < 0.001). The analysis revealed that only FT4 levels had significant differences between patients with HIV and healthy people (p = 0.013). CONCLUSION: Individuals with HIV are at risk of developing variable manifestations of thyroid abnormalities. While being not abundant in the HIV population, monitoring of thyroid dysfunction is essential due to the potential for progression to overt hypothyroidism and associated adverse health outcomes.