Thyroid function in multidrug-resistant tuberculosis patients with or without human  immunodeficiency virus (HIV) infection before commencement of MDR-TB drug regimen.

Olusoji Mayowa Ige1, Kehinde Sola Akinlade, Sheu Kadiri Rahamon, Victory Fabian Edem,Olatunbosun Ganiyu Arinola2
1. Department of Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria.
2. Deaprtment of Chemical Pathology, University of Ibadan/University College Hospital, Ibadan, Nigeria.

Abstract
Background: Mycobacterium tuberculosis and human immunodeficiency virus (HIV) are known to cause abnormal thyroid  function. There is little information on whether HIV infection aggravates alteration of thyroid function in patients with MDRTB.

Objectives: This study was carried out to determine if HIV co-infection alters serum levels of thyroid hormones (T3, T4) and  thyroid stimulating hormone (TSH) in patients with MDR-TB patients and to find out the frequency of subclinical thyroid dysfunction before the commencement of MDR-TB therapy.

Methods: This observational and cross-sectional study involved all the newly admitted patients in MDR-TB Referral Centre,  University College Hospital, Ibadan, Nigeria between July 2010 and December 2014. Serum levels of thyroid stimulating hormone (TSH),free thyroxine (fT4) and free triiodothyronine (fT3) were determined using ELISA.

Results:Enrolled were 115 patients with MDR-TB, out of which 22 (19.13%) had MDR-TB/HIV co-infection. Sick euthyroid syndrome (SES), subclinical hypothyroidism and subclinical hyperthyroidism were observed in 5 (4.35%), 9 (7.83%) and  2 (1.74%) patients respectively. The median level of TSH was insignificantly higher while the median levels of T3 and T4 were  insignificantly lower in patients with MDR-TB/HIV co-infection compared with patients with MDRT-TB only.

Conclusion: It could be concluded from this study that patients with MDR-TB/HIV co-infection have a similar thyroid function as patients having MDR-TB without HIV infection before commencement of MDR-TB drug regimen. Also, there is a  possibility of subclinical thyroid dysfunction in patients with MDR-TB/HIV co-infection even, before the commencement of  MDR-TB therapy.

Keywords:HIV, multidrug-resistant TB, subclinical thyroid dysfunction, thyroid hormones.