Anemia of chronic disease in patients with HIV infection: clinical and laboratory characteristics

Abstract

Aim. To provide clinical and laboratory characteristics of anemia of chronic disease in HIV infection in order to improve its diagnosis. Methods. The study included 63 HIV-infected patients with anemia of chronic disease. Assessed were the frequency of complaints and physical changes, erythrocyte indices, serum iron level, total iron-binding capacity of the blood, soluble transferrin receptor and erythropoietin markers of inflammation (ferritin, interleukin-1β, tumor necrosis factor-α, soluble receptor CD14, C-reactive protein). Comparison group consisted of a group of 35 patients with iron deficiency anemia. Results. The most frequent were complaints of weakness, fatigue and diarrhea. Hemoglobin level of the majority of patients corresponded to mild anemia. It often had a micro- or normocytic character (48.1±6.8 and 46.3±6.8% of patients, respectively), was normochromic (53.7±6.8% of patients) and hyporegenerative; in 94% of patients relative level of reticulocytes in the blood level was 0.2-1.2%; 87.3% had a reduced number of red blood cells. A negative relationship between levels of hemoglobin with erythropoietin (r=-0.5, p=0.0003) was established. Low levels of serum iron was typical for anemia of a chronic disease, as well as for iron-deficiency anemia. In patients with anemia of chronic disease revealed were significantly higher levels of soluble receptor CD14, C-reactive protein and ferritin and the relatively low level of total iron binding capacity of serum. Conclusion. Anemia of chronic disease in HIV infection is characterized by a predominance of light forms, the frequent lack of «typical for anemia» complaints; mainly micro or normocytic, normochromic types of process with low serum iron; hyporegeneration character against the backdrop of an adequate response to erythropoietin-synthesizing cells decrease in hemoglobin concentration; high levels of markers of inflammation (sCD14, C-reactive protein and ferritin) and relatively low total iron binding capacity of serum.