Thyroid function in children with perinatal human immunodeficiency virus type 1 infection

Objective: To study thyroid function in children with perinatal HIV-1 infec tion retrospectively and determine whether thyroid abnormalities are correl ated with clinical condition, disease progression, immunological impairment , and viral load. Study design and setting: Total (TT4) and free (FT3) thyr oxine, total (TT3) and free (FT3) triiodothyronine, reverse triiodothyronin e (rT(3)), thyrotropin (TSH), thyroglobulin (TG), and thyroid binding globu lin (TBG) were measured twice in 56 children with perinatal human immunodef iciency virus type 1 (HIV-1) infection. Median age at first determination w as 13.5 (range: 0.03-127.0) months; median age at second determination was 66.2 (range 3.42-147.4) months. Antithyroglobulin, antimicrosomal, thyroid peroxidase, and thyrotropin receptor antibodies were also evaluated. Fifty- three healthy children were selected as controls. Results: TT3, TT4, FT4, a nd TG were significantly reduced and rT(3), TBG, and TSH increased in child ren with HIV-1 infection when compared with controls. Thyroid dysfunction c orrelated with severe immunosuppression and high viral load early in life p receded the onset of the disease and worsened over time. Autoantibodies wer e negative in all children with HIV-1 infection in all determinations. Conc lusion: Thyroid abnormalities are observed early in the course of perinatal HIV-1 infection; thyroid dysfunction is particularly pronounced in childre n with severe immunosuppression and high viral load. Modifications of thyro id function precede worsening of clinical course in HIV-1 infected children .