THYROID DYSFUNCTION AND DYSLIPIDEMIA AMONG VIRALLY SUPPRESSED ADULTS LIVING WITH HIV AT MAUA METHODIST HOSPITAL, MERU COUNTY KENYA

Abstract

Human immunodeficiency virus (HIV) infection leads to progressive immune system decline, often requiring lifelong treatment to control viral replication and prevent complications. The use of combination antiretroviral therapy (cART) has significantly improved survival and health outcomes among people living with HIV (PLWH). However, the long-term use of cART has been linked to an increased risk of metabolic and endocrine disorders, including thyroid dysfunction, a condition known to negatively impact quality of life. This study investigated the prevalence and determinants of thyroid dysfunction and dyslipidemia among PLWH receiving care at Maua Methodist Hospital in Meru County, Kenya. A cross-sectional analysis was conducted using clinical records, demographic data, and laboratory investigations. Blood samples were tested to assess viral load, immune markers (CD4/CD8 counts and c-reactive protein (CRP)), thyroid hormone levels, and metabolic profiles. Data was analyzed using Microsoft Excel and all analyses were performed using STATA version 15.1 (STATA Corporation, College Station, TX, USA). The study employed descriptive statistics and binomial logistic regression analyses (both univariable and multivariable) to determine the prevalence and risk factors associated with thyroid dysfunction and dyslipidemia. Thyroid dysfunction was observed in 51.9% of the participants (95% CI: 50.8–53.2). The prevalence was notably higher in individuals receiving cART (77%) compared to those who were treatment-naïve (47%). Similarly, a higher rate was found among individuals with unsuppressed viral loads (97%) than those with viral suppression (83%). Statistical analysis revealed significant associations between thyroid dysfunction and HIV infection status (p<0.001), cART exposure (p<0.001), tuberculosis co-infection (p<0.001), and duration of HIV infection (p=0.002). Positive correlations were also observed between thyroid dysfunction, tuberculosis presence and the length of infection. Although there was a negative correlation with CD4 counts, it was not statistically significant. In addition, dyslipidemia was highly prevalent (96.7%) across the study population, with slightly higher rates in younger individuals, females, and those without formal employment. However, no significant associations were found between dyslipidemia and other factors including age, gender, viral load, duration of HIV infection and thyroid dysfunction. These findings underscore a significant burden of thyroid dysfunction and lipid abnormalities among PLWH, especially those on long-term therapy or with poor viral suppression. Routine screening for thyroid and lipid abnormalities should be considered in HIV care programs to enable early detection and intervention.