Human immunodeficiency virus, diabetes mellitus and thyroid abnormalities: Should we be screening?

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

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.

A Literature Review on SARS-CoV-2 and Other Viruses in Thyroid Disorders: Environmental Triggers or No-Guilty Bystanders?

A growing number of findings indicate a relationship between COVID-19 infection and thyroid dysfunction. This association is also strengthened by knowledge on the potential of viral infections to trigger thyroid disorders, although the exact underlying pathogenetic process remains to be elucidated. This review aimed to describe the available data regarding the possible role of infectious agents, and in particular of SARS-CoV-2, in the development of thyroid disorders, summarizing the proposed mechanisms and levels of evidence (epidemiological, serological or direct presence of the viruses in the thyroid gland) by which the infection could be responsible for thyroid abnormalities/diseases. Novel data on the association and mechanisms involved between SARS-CoV-2 vaccines and thyroid diseases are also discussed. While demonstrating a clear causal link is challenging, numerous clues at molecular and cellular levels and the large amount of epidemiological data suggest the existence of this relationship. Further studies should be taken to further investigate the true nature and strength of this association, to help in planning future preventive and therapeutic strategies for more personal and targeted care with attention to the underlying causes of thyroid dysfunction.

Thyroid Diseases and Thyroid Asymptomatic Dysfunction in People Living With HIV

Thyroid diseases (TDs) and thyroid asymptomatic dysfunctions (TADs) are correlated with Human Immunodeficiency virus (HIV) infection and Acquired ImmunoDeficiency Syndrome (AIDS) as well as many endocrine dysfunctions and dysregulation of hormonal axes. To date, available studies on People Living With HIV (PLWH) affected by thyroid diseases and asymptomatic dysfunctions are few and rather controversial. The purpose of the present non-systematic literature review is to recap the current knowledge on the main features of thyroid dysfunctions and disorders in PLWH. Large cohort studies are needed for a better comprehension of the impact, evolution and treatment of thyroid pathologies in the HIV-infected population.