Human immunodeficiency virus (HIV) infection is associated with various endocrine and metabolic abnormalities including thyroid disorder. The association between abnormalities of thyroid functions and HIV infection has been well documented. However, the correlation between CD4 count and thyroid functional abnormalities is still unclear. We conducted a systematic review and meta-analysis to determine the association between thyroid function tests and CD4 count among HIV-infected individuals.
Medline, Embase and the Cochrane Library databases for eligible studies from inception until September 2014 were searched. A manual search of reference lists of included articles, abstracts from IAS and AIDS conference and contact with authors were also performed. Reports of odds ratios (ORs) or evaluation data of CD4 count as an independent factor for thyroid hormone abnormalities were included. A random-effects model was used to calculate odds ratio and 95% confidence interval (CI). Heterogeneity was evaluated using Cochrane Q-test (p < 0.05) as well as I2 statistics (>50%).
Ten eligible studies comprising 1,895 study participants met our inclusion criteria and finally were included in this study to assess association between lower CD4 count (less than 200 cells/mm3) and thyroid functional abnormalities. In eight studies, meta-analysis demonstrated that lower CD4 count among HIV-infected individuals was significantly associated with hypothyroidism (pooled OR, 1.81; 95% CI: 1.27-2.58). In contrast, results of three studies did not reveal significant association of lower CD4 count with hyperthyroidism (pooled OR, 0.95; 95% CI: 0.38-2.40).
Lower CD4 count, particularly less than 200 cells/mm3, is associated with hypothyroidism. Therefore, these findings suggest thyroid function should be screened among HIV-infected individuals, particularly in those having a CD4 count of less than 200 cell/mm3.
A. Sanguankeo, None