Primary thyrotoxicosis in HIV-infected patients with signs of inflammatory syndrome of immune recovery after initiation of antiretroviral therapy: surgical aspects

Objective. To evaluate the characteristics of the course and results of treatment of primary thyrotoxicosis in HIV-infected patients with signs of immune reconstitution inflammatory syndrome after initiation of antiretroviral therapy. Materials and methods. A retrospective analysis was performed on 33 patients with primary thyrotoxicosis that developed after the initiation of antiretroviral therapy against the background of inflammatory syndrome of immune restoration. Thyroidectomy was performed in 16 patients (11 in the early stages and 5 in the late stages), while the remaining 17 patients received conservative treatment. The dynamics of thyrotropin, free thyroxine, and immune status (CD4+ cell count, viral load) were assessed, as well as the frequency of complications and recurrence of thyrotoxicosis. Results. After early thyroidectomy, the thyroid profile normalized in 81.8% of patients, after late thyroidectomy – in 20%, after drug therapy – in 29% (p