Tips from Other Journals

Hypothyroidism Common in Patients Infected with HIV


Am Fam Physician. 2004 Mar 15;69(6):1508-1509.

Case studies of patients with human immunodeficiency virus (HIV) infection have reported an increased incidence of thyroid dysfunction. There also have been more recent reports of Graves’ disease in patients taking highly active antiretroviral agents. Beltran and colleagues screened a cohort of HIV-infected patients to determine the prevalence of thyroid dysfunction.

A cohort of 350 patients with HIV was screened. Seven patients with hyperthyroidism and abnormal free triiodothyronine levels were not included in the final analysis. Overt hypothyroidism, defined as a thyroid-stimulating hormone (TSH) level above the normal range and a low free thyroxine (T4) level, was detected in 2.6 percent of patients. Subclinical hypothyroidism (i.e., elevated TSH level and normal free T4 level) was detected in an additional 6.6 percent of patients, and a low free T4 level was found in another 6.8 percent.

A further case-control comparison was performed for the hypothyroid and euthyroid patients. Older age, longer duration of HIV infection, lower CD4+ T-lymphocyte count, and several different antiretroviral medications were associated with hypothyroidism. Multivariate analysis showed a significant association only for lower CD4+ T-lymphocyte count and use of stavudine.

The authors conclude that hypothyroidism occurs more often in HIV-infected patients treated with highly active antiretroviral therapy, especially in patients with lower CD4+ T-lymphocyte counts and those taking stavudine. A few cases of hyperthyroidism were detected in patients taking highly active antiretroviral drugs.

Beltran S, et al. Increased prevalence of hypothyroidism among human immunodeficiency virus–infected patients: a need for screening. Clin Infect Dis. August 15, 2003;37:579–83.



Copyright © 2004 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact for copyright questions and/or permission requests.

Want to use this article elsewhere? Get Permissions


May 2022

Access the latest issue of American Family Physician

Read the Issue

Email Alerts

Don't miss a single issue. Sign up for the free AFP email table of contents.

Sign Up Now

Navigate this Article