A histological autopsy study of the thyroid gland in HIV infected adults at the University Teaching Hospital in Lusaka, Zambia

Abstract

Background: Despite the high prevalence of Human Immunodeficiency Virus (HIV) in Zambia, not much is known about the spectrum of thyroid lesions in patients with Acquired Immune Deficiency Virus, (AIDS). Patients with AIDS have increased prevalence of thyroid function abnormalities. It is therefore postulated the thyroid gland would be involved in AIDS patients. This study focused on the histologic appearances of the thyroid gland in HIV and AIDS patients on post mortem. The findings will provide evidence based recommendations on the management of thyroid diseases in the HIV infected in Zambia.

Objective: The aim of the study was to determine the histological appearances of adult thyroid glands in patients who died of HIV related diseases at UTH in the period 2010 to 2012.

Materials and Methods: This research was a descriptive retrospective study of adult thyroid glands collected at autopsy during the period 2010 to 2012. The study took place at the University Teaching Hospital (UTH) in the Department of Pathology and Microbiology in Lusaka, Zambia. A total of 200 thyroid gland paraffin blocked samples were obtained from the parent study tissue bank by convenient sampling. The inclusion criteria included samples from adult HIV patients who were admitted to UTH and died in hospital. The Paraffin blocked thyroid tissue samples were processed according to standard histopathology laboratory protocols at UTH which included sectioning and staining with hematoxylin and eosin. The slides were examined at light microscopic level. Clinical data was obtained from the available case notes.

Results: The sample size was 200 thyroid glands of which 123(62%) were males. Thyroid histopathological lesions were seen in 111 (56%) of the cases, of which 60 (54%) were male. The lesions included: Interstitial fibrosis 104 (52%), nonspecific chronic thyroiditis 42 (21%). Infectious diseases included Mycobacterium tuberculosis 2 (1%) and Cryptococcus neoformans 1(0.5%).

Conclusion: These findings outline the importance of thyroid function testing in HIV infected patients who may have subclinical thyroid dysfunction and infection.