Abstract:
Background: HIV infection weakens the immune system and can disrupt endocrine function, particularly
affecting the thyroid gland. While overt thyroid disease remains uncommon, subclinical abnormalities like
subclinical hypothyroidism and Graves’ disease are frequently observed, especially among patients on
antiretroviral therapy (ART) or with low CD4 counts. Immune reconstitution may trigger autoimmune thyroid
disorders. Early diagnosis through thyroid function tests (TSH, FT4, and T3) is essential to prevent
complications and improve outcomes in people living with HIV.
Objective: To assess the prevalence and associated factors of thyroid dysfunction among HIV Positive patients
on ART in Nekemte town, West Ethiopia,2024
Methods: A cross-sectional study design was conducted at the Nekemte Specialized Hospital among HIV
Positive patients, from June 11 to July 14, 2024. A total of 327 HIV positives patients were included in the study
by using systematic random sampling technique. The mobile KOBO toolbox was used to collect data on socio
demographic, HIV-related information, medical, and lifestyle factors. Five milliliter of venous blood was
collected using a sterile disposable syringe into a plain and EDTA tube, The samples were tested for CD4 T
lymphocyte levels using the BD FACSPresto system and TSH,FT4 and FT3 test was measured using a Cobas
e411 analyzer. The data were processed and analyzed using SPSS Version 23.0, Descriptive and inferential
statstics were used to describe and identify independent predictors respectively. P value less than 0.05 was
considered as statistically significant.
Result: The study found that 14.4% of respondents had abnormal in TSH, free triiodothyronine (FT3), and free
thyroxine (FT4) levels.The majority of respondents(40.4) were in the 40-49 age range, with a smaller
percentage in the 18-29 age range or older than 60. The most frequently prescribed medications were
Tenofovir(32.7), Lamivudine(33.0), and Dolutegravir(30.6). The 50-59 age group had a higher risk of thyroid
dysfunction than those in the 30-39 age range.The study also found that women had a 1.45 times greater chance
of subclinical hypothyroidism than men. Zidovudine ( AOR = 2.10, 95% CI: 1.35–3.27) users had a markedly
increased incidence of thyroid dysfunction compared to those on antiretroviral therapy (ART).
Conclusion: Asignificant number of HIV-positive patients receiving ART at Nekemte Specialized Hospital had
thyroid abnormalities, namely subclinical hypothyroidism. To reduce the risk of negative endocrine effects and
enhance patient outcomes, will be significant to monitor thyroid function for people using antiretroviral therapy
(ART) regimens such lamivudine, tenofovir, and dolutegravir female sex was significantly associated with
thyroid dysfunction, with women having higher odds of developing thyroid abnormalities compared to men