Important note: Information in this article was accurate in June 2000. The state of the art may have changed since the publication date.
Doctors in Dijon, France, noticed that four of their patients taking HAART developed symptoms of low levels of thyroid hormones in the blood. This condition is called hypothyroidism, symptoms of which can include:
The doctors decided to conduct a study to find out if any other of their patients taking HAART also developed hypothyroidism.
Nurses enrolled 207 PHAs (56 female, 151 male) whose average was 40. The doctors did not release CD4+ cell counts or viral load levels, but stated that roughly equal proportions of subjects had AIDS or were symptom free. Blood tests to measure thyroid hormone levels were performed.
After excluding four PHAs who had thyroid dysfunction prior to using HAART, the researchers found that about 10% or 22 PHAs had hypothyroidism. Eighteen PHAs had abnormal levels of thyroid hormones but no symptoms of hypothyroidism. No cases of high levels of thyroid hormones, a condition called hyperthyroidism, were detected.
The doctors found that PHAs with dysfunctional thyroid glands were taking relatively higher levels of d4T (stavudine) than PHAs who did not develop thyroid dysfunction. This difference in exposure to d4T between the two groups of people was statistically significant. The researchers think that d4T may affect the breakdown of thyroid hormones.
The researchers' results and theory need to be confirmed by other studies because the cause of the problem detected by the Dijon doctors may lie elsewhere. Indeed, in TreatmentUpdate 95, we published a short report in which ritonavir was found to decrease levels of the thyroid hormone supplement L-thyroxine. In the meantime, the French doctors suggest patients being treated with HAART, particularly those using d4T, should have their thyroid hormone levels checked.
1. Grappin M, Piroth L, Berges B, et al. Increased prevalence of subclinical hypothyroidism in HIV patients treated with highly active antiretroviral therapy. AIDS 2000;14(8):1070-1072.
2. Tseng A and Fletcher D. Interaction between ritonavir and levothyroxine. AIDS 1998;12(16):2235-6.
20000601
CATE10807
Copyright © 2000 - TreatmentUpdate. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Editor, The Canadian AIDS Treatment Information Exchange, 555 Richmond St. West, Suite 505, Box 1104, Toronto, ON, M5V 3B1 • Phone: 416-203-7122 • Toll Free: 1-800-263-1638 • Fax: 416-203-8284 http://www.catie.ca.
ÆGiS is made possible through unrestricted grants from Boehringer Ingelheim, Elton John AIDS Foundation, iMetrikus, Inc., the National Library of Medicine, and donations from users like you. Always watch for outdated information. This article first appeared in 2000. This material is designed to support, not replace, the relationship that exists between you and your doctor.
ÆGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.
Copyright ©1990, 2000. ÆGiS & the Sisters of Saint Elizabeth of Hungary. All materials appearing on ÆGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of ÆGIS, or the party credited as the provider of the content.