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Determination of thyroid hormonal levels in hiv positive individuals in nsukka community of south eastern nigeria

 

Table Of Contents


Chapter ONE

1.1 Introduction
1.2 Background of Study
1.3 Problem Statement
1.4 Objective of Study
1.5 Limitation of Study
1.6 Scope of Study
1.7 Significance of Study
1.8 Structure of the Research
1.9 Definition of Terms

Chapter TWO

2.1 Overview of Thyroid Hormones
2.2 HIV and Thyroid Dysfunction
2.3 Factors Affecting Thyroid Function in HIV Patients
2.4 Diagnostic Methods for Thyroid Hormone Levels
2.5 Relationship Between HIV and Thyroid Disorders
2.6 Management of Thyroid Dysfunction in HIV Patients
2.7 Previous Studies on Thyroid Hormones in HIV Patients
2.8 Gaps in Existing Literature
2.9 Theoretical Framework
2.10 Summary of Literature Review

Chapter THREE

3.1 Research Design
3.2 Population and Sampling
3.3 Data Collection Methods
3.4 Variables and Measurements
3.5 Data Analysis Techniques
3.6 Ethical Considerations
3.7 Research Limitations
3.8 Data Validity and Reliability

Chapter FOUR

4.1 Overview of Research Findings
4.2 Description of Study Participants
4.3 Analysis of Thyroid Hormone Levels in HIV Patients
4.4 Factors Influencing Thyroid Function in the Study Cohort
4.5 Comparison with Previous Research
4.6 Discussion on Implications of Findings
4.7 Recommendations for Clinical Practice
4.8 Areas for Future Research

Chapter FIVE

5.1 Summary of Research Findings
5.2 Conclusion
5.3 Contributions to Knowledge
5.4 Practical Implications
5.5 Recommendations
5.6 Areas for Future Research

Thesis Abstract

This study assessed the levels of cluster determinant 4 (CD4+) cell, total protein, triacylglycerol (TAG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), thyroid stimulating hormone (TSH) and thyroxine (T4), of one hundred (100) subjects of which twenty-four (24) were healthy subjects which represented normal control (Group1), twenty-eight (28) were HIV-positive subjects who were on treatment with administration of antiretroviral therapy (ART) as Group 2 and forty-eight (48) were HIV-positive subjects who were not on treatment with antiretroviral therapy (NART) (Group 3) and also to correlate the variation in total protein and lipid profile with the CD4+ cell count for each of the study groups. Within each of the study groups, subjects were further grouped based on age range i.e. 10-30/yrs, 31-50/yrs and 51-70/yrs irrespective of gender. Blood samples of subjects from Bishop Shanahan hospital, Nsukka were collected for this study. The CD4+ cell count, total protein, TAG, TC, HDL-C, LDL-C, TSH and T4 of group 1 were 1144.63±46.21 cells/µL, 7.09±0.21 g/dL, 117.50±8.85 mg/dL, 193.41±24.76 mg/dL, 54.34±8.29 mg/dL, 112.76±22.08mg/dL, 0.35±0.17 µIU/ml and 14.91±2.47 ng/ml respectively; group 2 were 417.75±45.39 cells/µL, 6.99±0.12 g/dL, 130.01±9.04 mg/dL, 158.42±26.31mg/dL, 39.50±15.45 mg/dL, 96.54±29.76 mg/dL, 0.30±0.13 µIU/ml and 14.55±1.48 ng/ml respectively while those of group 3 were 409.73±28.59 cellsr/µL, 6.93±0.14 g/dL, 129.90±9.01mg/dL, 156.15±30.61 mg/dL, 41.93±16.95 mg/dL, 88.13±26.79 mg/dL, 0.32±0.19 µIU/ml and 14.39±1.97 ng/ml respectively. The CD4+ cell count were found to be significantly lower (p< 0.05) in groups 2 and 3 of patients when compared to that of uninfected healthy controls. Total protein concentration of the study groups were found to be within the normal range of 6.0 – 8.2g/dl. Furthermore, TC, HDL and LDL concentration were found to be significantly lower (p<0.05) in groups 2 and 3 irrespective of therapy except for TAG which was significantly higher (p<0.05) when compared to group 1. Also there was a weak positive correlation between CD4+ cell count and HDL-C among group 2 (ART) subjects. TSH and T4 concentrations were found to be lower in the HIV positive patients (groups 2 and 3) when compared to healthy controls (group 1). Again, concentration of TAG, TC, HDL and LDL fluctuated among the various age groups with no definite pattern. Conclusion from this study shows an alteration of lipid profile in HIV-positive patients irrespective of therapy which could be attributed to low CD4+ cell counts. It was also observed that total protein may not be useful as a marker of HIV infection since values obtained were within the normal range. Conditions of individuals with HIV infection may be attributed to hypothyroidism since TSH concentration is lower when compared to the healthy uninfected controls.

Thesis Overview

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