Infectious and neoplastic disorders of the thyroid in AIDS patients: an autopsy study

ABSTRACT

The course of human immunodeficiency virus infection and the acquired immunodeficiency syndrome can be complicated by a variety of endocrine abnormalities. This article describes the findings of a prospective study of 100 AIDS patients with thyroids compromised by infectious agents or neoplastic disorders from a time period before the use of highly active antiretroviral regimens. A wide range of bacterial, fungal, viral, and neoplastic disorders were observed. Mycobacetrium tuberculosis was recorded in 23 percent of the patients, cytomegalovirus in 17 percent, Cryptoccocus in 5 percent, Mycobacterium avium in 50 percent, Pneumocystis in 4 percent, and other bacteria or fungi in 7 percent. Kaposi's sarcoma was recorded in 2 percent of patients and occult papillary carcinoma in 4 percent. Four patients had dual infections of the thyroid. The mean weight of the thyroid was lower than normal, and 1 case of thyroid follicular atrophy is presented. A review of the medical literature on thyroid disorders in HIV-infected patients is included. Physicians caring for HIV patients should be aware of the possibillity of thyroid dysfunction in their patients.