Possible Impact of Thyroid Dysfunction on Menstrual Cycle in HIV/TB Co-infected Females in NAUTH, Nnewi, Nigeria

Abstract

Background: Thyroid dysfunction is among the commonest endocrinopathies in HIV as well as Tuberculosis infection and can pose unique consequences on women’s reproductive health. Aim of Study: The present study aimed to evaluate the impact of thyroid dysfunction on menstrual cycle of HIV/TB Co-infected females in Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria. Materials and Methods: A total of 210 reproductive aged women (15-45 years) were randomly recruited for the study and grouped into: (i) Symptomatic HIV females (n=30); (ii) Symptomatic HIV females on ART (n=30); (iii) Symptomatic TB females (n=30); (iv) Symptomatic TB females on ATT (n=30); (v) Symptomatic HIV/TB females (n=30), (vi) Symptomatic HIV/TB females on therapy (n=30); and (vii) Control females (n=30). After due consent, blood samples were collected at the follicular (Fp) and luteal phases (Lp) of their menstrual cycle for determination of thyroid indices (FT3 (ng/ml), FT4 (µg/dl, TSH (µIU/ml) using enzyme-linked immunosorbent assay (ELISA) method, CD4+ T-cells (/µl) using Cyflow SL Green Cytometer. Results: There was significantly lower FT3 but significantly higher TSH values in Symptomatic HIV and Symptomatic HIV/TB females and significantly lower FT3 with normal TSH values in Symptomatic TB compared respectively with Control females at both phases of menstrual cycle (P=.05). CD4 T-cells counts was significantly lower in all test groups compared to Control females at both phases of menstrual cycle (P=.05) and  significantly higher in Symptomatic HIV on ART, TB on ATT and HIV/TB females on treatment compared to their counterparts not on therapy (P=.05 respectively). The thyroid indices showed hypothyroidism in Symptomatic HIV females and Symptomatic HIV/TB females while euthyroid sick syndrome was observed in Symptomatic TB females with significant drop in CD4 T-cells. Conclusions: The study showed significant derangement in thyroid indices and CD4 T-cells in all the study subjects. Early diagnosis and treatment of thyroid dysfunction is beneficial.