THE RELATION BETWEEN THYROID-FUNCTION AND NUTRITIONAL-STATUS IN HIV-INFECTED PATIENTS

OBJECTIVE The effects of human immunodeficiency virus (HIV) infection on thyroid function have been reported in only a few studies with disc repant results. The aim of this study was to assess the relation betwe en nutritional status and thyroid function in HIV infected patients. D ESIGN Prospective, cross-sectional study. SETTING A 500-bed teaching a nd referral hospital serving a population of 450 000. PATIENTS Seventy -five consecutive HIV infected patients between 21 and 40 years of age (mean 31.8 +/- 0.9 years). MEASUREMENTS Nutritional status was evalua ted using the body mass index (BMI), triceps skinfold thickness (TSF), mid-arm muscle circumference (MAMC), and serum albumin concentration (SA). Hormone assays for serum T4, free thyroxine index (FTI), T3, rev erse triiodothyronine (rT3), thyroxine-binding globulin (TBG), TSH and simultaneous CD4 lymphocyte counts were determined in all patients.RE SULTS Clinical stage was significantly related to nutritional status ( P = 0.0001 for BMI, P = 0.0002 MAMC). The more poorly nourished groups had low mean serum T3 and rT3 levels, particularly for muscular (P = 0.0001 for T3 and P = 0.0076 for rT3) and visceral (P = 0.00001 for T3 and P = 0.0021 for rT3) protein compartments. Multivariate analysis s howed that two factors, SA and MAMC, correlated significantly and inde pendently with serum T3 and rT3. CONCLUSIONS A close relation exists b etween serum thyroid hormone levels and nutritional status in HIV infe cted patients. These patients are probably euthyroid and the abnormal findings in the thyroid function tests are thus a reflection of the se verity of illness.