Occurrence of Anti-thyroid Autoantibodies in Children Vertically Infected with HIV-1

Abstract

Autoimmune phenomena, especially occurrence of non organ-specific autoantibodies, are common in congenitally acquired HIV infection, mostly in the symptomatic stages of the disease. Anti-thyroid autoantibodies detected in adult patients represent the only type of organ-specific autoantibodies reported in HIV infection. As far as we know, occurrence of these autoantibodies has not been observed in HIV infected children. In this study thyroid biochemical pattern and possible occurrence of anti-thyroid autoantibodies were investigated in 40 vertically HIV infected, 18 seroreverted and 22 healthy children. 34% of HIV infected symptomatic children showed anti-thyroglobulin antibodies. Asymptomatic patients, seroreverted and healthy controls did not show any anti-thyroid antibodies at the time of the study. High Tg levels were observed in 38% of the 40 HIV infected patients and high TSH concentrations were found in 27.5% of the HIV children. High TSH values were more frequently observed in the infected children with moderate or severe immunocompromised status. Thyroxine binding globulin levels were high in 68% of the HIV children and in 22% of the seroreverted. The finding of anti-thyroid autoantibodies in congenital HIV infected children confirms the thyroid's involvement in HIV infection and provides more information about the wide spectrum of autoimmune phenomena observed in the infection.

Sequential Occurrence of Thyroid Autoantibodies and Graves’ Disease after Immune Restoration in Severely Immunocompromised Human Immunodeficiency Virus-1-Infected Patients

“…Thyroid abnormalities such as hypothyroidism with TPOAb in adults or hyperthyroidism with antithyroglobulin antibodies (TgAb) in children have been reported (15,16). Here, we report on the occurrence of GD, a true autoimmune disorder characterized by the presence of TgAb, TPOAb, and TSH-RAb, after CD4 ϩ cell reconstitution on HAART.…”

Endocrinopathies in Children Infected with Human Immunodeficiency Virus

“…Thyroid autoantibodies have been described in up to 34% of children with HIV infection. 59 However, other studies fail to confirm this association. [56][57][58] Hashimoto thyroiditis has also been reported in an adult after initiation of HAART, and is considered a potential complication of immune reconstitution inflammatory syndrome (IRIS).…”

“…Reported frequencies vary from 2% 54 to 14% 58 ; the clinical significance remains unclear. High TSH values are more frequently observed in patients with moderate to severe immunosuppression 59 and an inverse correlation exists between CD41 cell count and TSH. Many children with HIV have normal to high levels of T3 and T4, normal to increased TSH, and increased thyroid-binding globulin (TBG) with normal to low levels of FT4.…”

“…56 These changes may be explained by a progressive increase in TBG levels, a finding that has been confirmed by other investigators. 57,59 These abnormalities in thyroid function become more significant as CD4 count decreases. TBG remains increased even after treatment with thyroid hormone and normalization of other thyroid indices.…”

Extensive viral mimicry of 22 AIDS-related autoantigens by HIV-1 proteins and pathway analysis of 561 viral/human homologues suggest an initial treatable autoimmune component of AIDS

“…NGF nerve growth factor (Titanji et al, 2003) Regulates the survival of B cells, and its levels are decreased in AIDS patients an effect correlated with B cell loss (Titanji et al, 2003) RBPJ NP_005340 recombination signal binding protein for immunoglobulin kappa J region (cerebellar soluble lectin) increased autoantibodies in the CSF of AIDS patients (Hagberg et al, 1992) Component of NOTCH signalling regulating B-and T-cell and dendritic cell development and haematopoiesis (Kojika & Griffin, 2001;Tanigaki et al, 2003;Tanigaki et al, 2004;Feng et al, 2010) Thyroglobulin autoantibodies observed in HIV infected children (Fundaro et al, 1998) Used in the synthesis of thyroxine and triiodothyronine. Thyroid hormones play an important role in preventing the decline in T-and B-cell efficiency in ageing (El Shaikh et al, 2006;Chen et al, 2010).…”