Anemia In HIV-infected Patients Research Articles

Evaluating anemia in HIV-infected patients using chest CT.

The aim of this study was to investigate the role of the Hounsfield unit value of chest CT non-contrast enhanced scan in evaluating the severity of anemia in HIV-infected patients. Patients with HIV infection combined with anemia admitted to the Kunming Third People's Hospital were retrospectively collected and divided into mild anemia, moderate anemia, and severe anemia groups by peripheral hemoglobin (HB) content and calculated the ratio of ventricular septum density (VSD) to left ventricular density (LVD) and VSD to right ventricular density (RVD); then, the above patients were divided into the critical value group and the non-critical value group according to HB and compared the differences of LVD, RVD, VSD/LVD, and VSD/RVD in the two groups of patients. A total of 126 patients were included, with a mean age of 47.9 ± 11.1 years; 43 cases were in the mild anemia group, 59 cases were in the moderate anemia group, and 24 cases were in the severe anemia group; the differences in LVD, RVD, VSD/LVD, and VSD/RVD were significant in the three groups; VSD/LVD was an independent predictor for the diagnosis of anemia critical value in the non-critical value group vs critical value group by multifactorial binary logistic regression analysis, and the ROC was plotted using VSD/LVD with an area under the curve of 0.731. The measurement of cardiac cavity density and ventricular septal density under CT plain film scan has a high accuracy in evaluating the severity of anemia in patients with HIV infection and can quickly determine the severity of HIV infection in the early stage and treat it as soon as possible.

A Case-Control Study of the MTHFR C665T Gene Polymorphism on Macrocytic Anemia Among HIV-Infected Patients Receiving Zidovudine.

BackgroundMacrocytic anemia is the most common anemia in HIV-infected patients receiving zidovudine, and is closely related to folate and vitamin B12 deficiencies. Homocysteine >10 μmol/L and increased MMA (methylmalonic acid) levels >24.8 ng/mL indicate high/low folate and vitamin B12 deficiencies. Furthermore, MTHFR (Methylene-tetrahydrofolate-reductase) plays an essential role in the transmethylation of homocysteine to methionine and is related to DNA synthesis. The MTHFR C665T gene polymorphism decreases the activity of MTHFR, which culminates in homocysteinemia. Therefore, this case-control aims to assess the role of the MTHFR C665T gene polymorphism on the risk of macrocytic anemia among HIV-infected individuals receiving zidovudine.MethodsThis study was conducted using an unmatched case-control design and the participants were HIV-infected adults aged 20 to 59 years old, receiving zidovudine for four weeks and above. A sample of 232 patients was divided into case group with macrocytic anemia and the control having no anemia. Multivariate logistic regression analysis was then implemented to determine the risk factors.ResultsThe results showed that there was a significant difference in the number of female and male patients namely 51.3% and 48.7%, respectively, with p< 0.001. Moreover, the mean age of the cases and control group was 41.9 ± 9.4 and 36.2 ± 8.3. Regarding education, there were significant differences between subjects with low and high education 47.8% vs 52.2% with p<0.001. The majority of patients or 90.95% had taken AZT for more than 6 months. The logistic regression analysis test results showed that sex, age, education level, duration of AZT use, and homocysteine levels were predictors of macrocytic anemia with p<0.05, while MTHFR C665T gene polymorphism and MMA levels were not risk factors.ConclusionMTHFR C665T gene polymorphism does not contribute to the incidence of macrocytic anemia among HIV-infected individuals receiving zidovudine.

Erythropoietin and iron for anemia in HIV-infected patients undergoing maintenance hemodialysis in China: a cross-sectional study

BackgroundAnemia is a common complication of chronic kidney disease (CKD) and HIV infection. The number of people living with HIV on hemodialysis (HD) is increasing. However, there is no data about anemia and related therapies in this kind of patients in China. We aim to assess the difference in hemoglobin (Hgb) and treatments like erythropoietin and iron between HIV-HD patients and HD patients in Chengdu, China.MethodsThis cross-sectional study was conducted with data collection from January 2020 to June 2020. Thirty-four HIV-infected HD patients and thirty-five non-HIV-infected HD patients were included. Age, gender, dialysis vintage, single-pool (sp) Kt/V, Hgb, the dose of erythropoietin, ferritin, use of iron preparations, and serum albumin were collected in all patients. Time since HIV diagnosis, counts of CD4 + T cells, HIV RNA, and antiretroviral therapy for HIV infection were collected in HIV-infected patients. T-test, Mann–Whitney U test, and chi-square statistics were applied in SPSS.ResultsThe Hgb of HIV-HD and HD groups were 105.70 (95.93–112.08) g/L and 112.00 (93.00–126.00) g/L respectively (P = 0.064). There was a statistically significant higher erythropoietin dosage used in the HIV-HD population (222.55 ± 115.47 U/kg/week) compared to the HIV-negative HD group (161.86 ± 110.31 U/kg/week) (P = 0.029). 16/34 (47.06%) HIV-HD patients and 5/35 (14.29%) HD patients were treated with iron preparations (P = 0.003). The ferritin levels were 316.50 (117.38–589.75) ng/ml and 272.70 (205.00–434.00) ng/ml in HIV-HD and HD groups respectively.ConclusionsA higher erythropoietin dosage and a higher probability of iron preparations may be required to maintain Hgb in HIV-HD patients compared with HD patients.

High Prevalence of Anemia among Human Immunodeficiency Virus-Infected Patients: A Cross-sectional Study in Bali-Indonesia

Anemia is a common condition found among Human Immunodeficiency Virus (HIV)-infected patients. T-cells that are infected with HIV virus can directly suppress the growth of progenitor cells in the bone marrow so that affecting the hemopoiesis resulted in anemia. These hematological abnormalities could potentially cause serious clinical implications. This study was conducted to determine the prevalence of anemia in HIV-infected patients in Bali. It was ahospital based cross-sectional studyconducted at two public hospital in Bali-Indonesia. A total of 243 medical record data from HIV-infected patients atWangaya Hospital Denpasar Bali and Sanjiwani Hospital Gianyar Bali between 2009 -2017 were included in analysis. Prevalence of anemia in antiretroviral (ART)-naïve patients and in patients on ART were 60.8% and 40.3%, respectively. Leucopenia and thrombocytopenia were found 8.2% and 9.4%, respectively, in ART-naïve group. While in patients with ART group leucopenia and thrombocytopenia were accounted for 6.9% and 4.3%, respectively. There was a significant difference in prevalence of anemia between ART-naïve patients and patients on ART (60.8% vs. 40.3%; p &lt; 0.05). Although the prevalence of anemia was lower in patients on ART, but anemia continues to be common in a substantial portion of HIV-infected persons. Another studies are still needed to addressing the impact of anemia on HIV-infected individuals, as well as treatment strategies and future research directions.

Association between Parvovirus B19 and anemia in HIV-infected patients.

Background: Human parvovirus B19 (B19V) can cause anemia in some patients, including those with compromised immunity system. There are a few studies on molecular epidemiology of B19V and its association with anemia in Iran. Therefore, the aim of this study was to determine the B19V DNA, IgM, IgG, genotyping, and viral load in HIV patients in different groups of pregnant women, general population, injection drug users (IDU), and Elite controllers. Also, the possible association of B19V with anemia was studied. Methods: In this case-control study, B19V DNA, anti-B19V IgM, anti-B19V IgG, viral load, and hemoglobin level were assessed in 113 HIV positive patients and 72 healthy controls. Also, CD4+ T cell counts and HIV load were measured in the patients’ group. All statistical analyses were done using STATA 14.2 software (Stata Corporation, College Station, Texas, USA). P value < 0.05 was considered statistically significant. Results: Among HIV patients, 19 (16.8%) cases had B19V DNA, 3 (2.7%) had B19V IgM, and 7 (6.2%) had B19V IgG. In control group, the prevalence of B19V DNA, IgM, and IgG was 6 (8.33%), 7(9.7%), and 19 (26.4%), respectively. In subpopulations based on transmission routes, general population had the highest B19V IgG and DNA positivity prevalence and viral load level. There was no significant association between B19V antibodies and DNA with anemia. Conclusion: The results demonstrated that B19V infection cannot be considered as a high-risk factor for anemia in adult HIV patients. However, further studies are needed to determine the exact role of B19V infection in HIV patients.

Association between Parvovirus B19 and anemia in HIV-infected patients

Association between Parvovirus B19 and anemia in HIV-infected patients

Anemia, Iron Deficiency, and Iron Supplementation in Relation to Mortality among HIV-Infected Patients Receiving Highly Active Antiretroviral Therapy in Tanzania.

Anemia in HIV-infected patients improves with highly active antiretroviral therapy (HAART); however, it may still be associated with mortality among patients receiving treatment. We examined the associations of anemia severity and iron deficiency anemia (IDA) at HAART initiation and during monthly prospective follow-up with mortality among 40,657 adult HIV-infected patients receiving HAART in Dar es Salaam, Tanzania. Proportional hazards models were used to examine the associations of anemia severity and IDA at HAART initiation and during follow-up with mortality. A total of 6,261 deaths were reported. Anemia severity at HAART initiation and during follow-up was associated with an increasing risk of mortality (trend tests P < 0.001). There was significantly higher mortality risk associated with IDA at HAART initiation and during follow-up versus no anemia or iron deficiency (both P < 0.001). These associations differed significantly by gender, body mass index, and iron supplement use (all interaction test P < 0.001). The magnitude of association was stronger among men. Mortality risk with severe anemia was 13 times greater versus no anemia among obese patients, whereas it was only two times greater among underweight patients. Higher mortality risk was observed among iron supplement users, irrespective of anemia severity. Anemia and IDA were significantly associated with a higher mortality risk in patients receiving HAART. Iron supplementation indicated an increased mortality risk, and its role in HIV infections should be examined in future studies. Given the low cost of assessing anemia, it can be used frequently to identify high-risk patients in resource-limited settings.

Age and CD4 count are dominant factors in the prediction of anaemia in Javanese HIV patients.

Anaemia in Human Immunodeficiency Virus (HIV) infection is multifactorial and an increasingly important variable to consider in the management. This is the first study of anaemia in HIV infection in the Javanese population, which constitutes the largest ethnic group in Indonesia. The aim of this study was to determine the factors which are associated with anaemia in Javanese patients with HIV infection. This study applied a cross-sectional design involving HIV patients in Dr Kariadi Hospital and Balai Kesehatan Paru Masyarakat (BKPM), Semarang, Indonesia. The characteristic data of the subjects were age, gender, BMI, duration of therapy and antiretroviral (ARV) drugs. Haematology tests were conducted using flow cytometry. The prevalence of anaemia in HIV-infected patients was 21 (38.88%). Macrocytic anemia was found as a majority (12; 57.1 %) in anaemic patients. The risk factors which were found to be associated with increase of anaemia were white blood cells (WBC) <5.0 x 109/L and CD4 >200.0 cells/μL (p<0.05). A correlation between anaemia and age (r=0.49, p<0.01), duration of treatment (r=0.35, p<0.01), CD4 count (r=-0.42, p<0.01), total bilirubin (r=-0.28, p<0.05), and unconjugated bilirubin (r=-0.29, p<0.05) was identified. Age (p=0.023) and CD4 count (p=0.07) were the dominant factors in the multivariate analysis. Age and CD4 count are the dominant factors in determining of anaemia in Javanese patients with HIV infection.

Anaemia in pregnancy in a setting of high HIV prevalence rates

Background: Although there is much literature on anaemia in pregnancy, there are limited data on anaemia specific to HIV in pregnancy. The aim of this study was to determine the prevalence of anaemia among HIV-infected antenatal attendees at their first visit.Methods: This was a secondary analysis of 2 000 antenatal attendees enrolled into a study on anaemia in pregnancy and was carried out at a regional hospital from 2012–2014. Demographic and clinical data including anaemia, perinatal and maternal outcomes of HIV infected women were analysed.Results: Of the 2 000 recruited, 854 (42.7%) were anaemic, 943 (47.2%) were infected with HIV, and 609 (64.6%) HIV-infected women had anaemia. There was a significant difference in the prevalence of anaemia in HIV-infected patients on antiretroviral (ARV) treatment compared to untreated patients (41.4% vs 92.1%; p 0.0001). Mild grades of anaemia were common in HIV-infected patients on ARVs, while moderate to severe grades were most common in patients who were not on ARVs. Besides birthweight and hypertensive disorders of pregnancy, there was no significant difference in neonatal and maternal outcomes irrespective of duration of ARV treatment.Conclusions: There was a high prevalence of anaemia among HIV-infected, untreated pregnant women. Assessment of anaemia at the first antenatal visit is, therefore, essential.

The impact of antiretroviral therapy on iron homeostasis and inflammation markers in HIV-infected patients with mild anemia

BackgroundAnemia is frequent during HIV infection and is predictive of mortality. Although cART has demonstrated to reduce its prevalence, several patients still experience unresolved anemia. We aimed to characterize iron homeostasis and inflammation in HIV-infected individuals with mild anemia in relation to cART.MethodsIn this retrospective cohort study, HIV-infected patients with mild anemia, CD4+ cells > 200/mm3 at baseline, maintaining virological response for 12 months after cART starting were selected within the Standardized Management of Antiretroviral Therapy Cohort (MASTER) cohort. Several inflammation and immune activation markers and iron homeostasis indexes were measured in stored samples, obtained at cART initiation (T0) and 12 months later (T1). Patients were grouped on the basis of hemoglobin values at T1: group A (> 13 g/dl) and B (< 13 g/dl). Wilcoxon rank sum test was used to compare biomarker values. Pearson correlation coefficients were calculated for all variables.ResultscART improved CD4+ and CD8+ cell counts and their ratio, but this effect was significant only in group A. Only these patients had mild iron deficiency at T0 and showed higher transferrin and lower percentage of transferrin saturation than patients of group B, but differences disappeared with cART. cART decreased inflammation in all patients, but group B had higher levels of all markers than group A, reaching statistical significance only for IL-8 values at T1 (16 vs 2.9 pg/ml; p = 0.017). Hepcidin and IL-6 levels did not show significant differences between groups. Hemoglobin levels both at T0 and T1 did not correlate with any marker.ConclusionsBaseline mild anemia in HIV-infected patients cannot always be resolved with durable efficient cART, possibly due to residual inflammation or immune activation rather than unbalanced iron homeostasis. Further research is needed on cytokine profiling to understand the mechanisms that induce anemia in HIV with suppressive cART.

Anaemia in pregnancy in a setting of high HIV prevalence rates

AbstractBackground: Although there is much literature on anaemia in pregnancy, there are limited data on anaemia specific to HIV in pregnancy. The aim of this study was to determine the prevalence of anaemia among HIV-infected antenatal attendees at their first visit.Methods: This was a secondary analysis of 2 000 antenatal attendees enrolled into a study on anaemia in pregnancy and was carried out at a regional hospital from 2012–2014. Demographic and clinical data including anaemia, perinatal and maternal outcomes of HIV infected women were analysed.Results: Of the 2 000 recruited, 854 (42.7%) were anaemic, 943 (47.2%) were infected with HIV, and 609 (64.6%) HIV-infected women had anaemia.There was a significant difference in the prevalence of anaemia in HIV-infected patients on antiretroviral (ARV) treatment compared to untreated patients (41.4% vs 92.1%; p < 0.0001). Mild grades of anaemia were common in HIV-infected patients on ARVs, while moderate to severe grades were most common in patients who we...

Anemia in combined antiretroviral treatment-naive HIV-infected patients in China: A retrospective study of prevalence, risk factors, and mortality.

Anemia is one of the most important complications of HIV infection. In China, the prevalence, risk factors, and association between anemia and prognosis in HIV-infected patients are poorly elucidated. We analyzed data from 3452 HIV-infected patients not yet on combined antiretroviral therapy (cART) attending Beijing Ditan Hospital from June, 2003 to December, 2015. The overall prevalence of anemia was 9.8% (7.6% mild, 1.9% moderate, and 0.2% severe anemia). Female sex (odds ratio [OR] = 3.71, 95% confidence interval [CI]: 1.46-6.51, p = 0.003), age 40-59 years (OR = 2.54, 95% CI: 1.59-4.05, p < 0.001), body mass index < 18.5 kg/m2 (OR = 2.23, 95% CI: 1.31-3.79, p = 0.003), baseline HIV RNA CI: 1.32-5.99, p = 0.007) were risk factors for anemia. Age 40-59 years (adjusted hazard ratio [AHR] = 5.76, 95% CI: 1.62-20.55, p = 0.007), and anemia ‒ mild (AHR = 7.46, 95% CI: 1.48-37.50, p = 0.015), moderate (AHR = 9.89, CI: 1.35-72.38, p = 0.024), and severe (AHR = 28.29, 95% CI: 2.75-290.54, p = 0.005) anemia ‒ were associated with an increased hazard of death. In this cohort, mild anemia was most common. Anemia was associated with female sex, older age, lower body mass index, lower baseline CD4 count, and higher viral load. Moreover, anemia was associated with an increased risk of death. These findings should promote awareness among physicians to make a timely diagnosis of HIV and to help physicians prioritize prevention and intervention strategies for anemia in HIV-infected patients.

Serum Hepcidin Detects Iron Deficiency Anemia in HIV Infected Patients with Anemia of Inflammation

INTRODUCTION: The etiology of HIV- associated anemia is multifactorial. We previously found a high prevalence of anaemia of inflammation and anemia due to micronutrient deficiencies in HIV patients (Eur J Pediatr 2012, 17:531). Inflammatory disease confounds the value of standard diagnostic markers, posing a challenge to the detection of iron deficient and iron-restricted erythropoiesis. Using serum hepcidin as a biomarker, we tested the hypothesis that total body iron stores like inflammatory signals would also influence serum hepcidin levels in patients with HIV infection.METHODS: Healthy subjects, patients with pure iron deficiency anemia (IDA) andpatients with HIV infection were prospectively enrolled after obtaining informed consent. Using sex adjusted WHO values for anemia diagnosis, ferritin <12µg/L, and CRP values, subjects were categorized into healthy and IDA groups (N Engl J Med 2015, 373:485). Using age adjusted WHO values for anemia, patients with HIV were divided into anemic and non-anemic groups. Using the soluble transferrin receptor (sTfR)/log ferritin (F) index, we defined those subjects with an sTfR-F index < 1.03 as having anemia of inflammation (AI) and those subjects with an sTfR-F index ≥1.03 as having IDA superimposed on AI (Am J Hematol. 2011, 86:923). All laboratory analytes were measured using standard commercial assays.RESULTS: The demographic characteristics of the different groups in the study population are shown in table 1. Compared with healthy controls, mean hemoglobin was significantly lower in patients with pure IDA, HIV patients with anemia, and HIV patients without anemia (p<0.001). The serum soluble transferin receptor (sTfR) levels and serum erythropoietin levels were significantly elevated in pure IDA patients (p<0.001) and HIV patients with anemia (p<0.001) compared with healthy controls, reflecting erythropoietic stress. Compared with healthy controls, serum hepcidin levels were markedly lower in pure IDA patients (p<0.01) and HIV patients with anemia suggesting that iron status influenced hepcidin levels more profoundly than inflammation in HIV infected patients. We also measured erythrocyte ZPP levels and found them to be significantly higher in pure IDA patients (p<0.001) and HIV patients with anemia (p<0.001) compared to healthy controls. All HIV patients with anemia had an sTfR-F index ≥1.03 suggesting the presence of IDA superimposed on AI. Interestingly, serum hepcidin levels correlated inversely with the sTfR-F index in both patients with pure IDA (ρ=-0.76; p<0.001) and in HIV patients with anemia (ρ=-0.4; p<0.02). Similarly, ZPP levels correlated linearly with the sTfR-F index in pure IDA patients (ρ=0.6; p<0.002) and in HIV patients with anemia (ρ=0.5; p<0.001).CONCLUSION: Our data shows significant differences in serum hepcidin and erythrocyte ZPP levels in healthy, IDA and HIV patients. These two biomarkers could be included in the panel of diagnostic tests used to detect iron deficiency anemia superimposed on anemia of inflammation. Further studies are needed to provide the appropriate cut-off values with which IDA can be detected with appropriate sensitivity and specificity in patients with anemia of inflammation. Such data may also be helpful in monitoring therapeutic responses to iron.Table 1Haematological and biochemical parametersHealthy(n = 45)Pure IDA(n=33)HIV with anemia(n=46)HIV without anemia(n=46)Age ± SD31±7.525±3.635±11.939±12Hemoglobin ± SD(g/dl)15.2±1.210.1±1.3a,c,d11±1.1a,d13.8±1.3aMCV ± SD85±4.274±7.780±8.785±4.6Biochemical parametersSerum Ferritin*(ng/mL)57 (43, 83)4.5a,c,d (3.1, 7)14a,d (7, 34)47 (32, 130)Serum sTfR*(mg/L)1.7b,c (1.3, 2)4.3 (3, 6.3)2.5 (2, 3.7)1.8b,c (1.3, 2.1)Serum Erythropoietin*(mU/mL)6.5b,c (4.9, 9.8)40 (28, 61)20b (13, 32)10b,c (5, 14)BiomarkersSerum Hepcidin*(ng/mL)20.6 (14.2, 25.6)0.5a (0.1, 3.3)11.6b (2.9, 29.8)Erythrocyte ZPP*(μmol/mol heme)50b,c (40, 58)200 (117, 247)101b (69, 131)56b,c (42, 75)*All non Gaussian distributed data are presented as median (25th percentile, 75th percentile); ap < 0.05 compared with healthy subjects, bp < 0.05 compared with pure IDA patients, cp < 0.05 compared with HIV anemia patients, dp < 0.05 compared with HIV without anemia patients. DisclosuresNo relevant conflicts of interest to declare.

High Incidence of Zidovudine Induced Anaemia in HIV Infected Patients in Southern Odisha.

Zidovudine (AZT), a nucleoside reverse transcriptase inhibitor was the first breakthrough in AIDS therapy in 1990.This study was conducted with an aim to determine prevalence of AZT induced anaemia in HIV infected patients initiated on AZT containing anti retroviral therapy(ART) regimen and also to find out any risk factor for causing AZT induced anaemia. Study was carried out in ART centre, M.K.C.G, MCH, Berhampur between Jan 2009 and Dec 2011. HIV infected patients registered at ART centre were treated according to National AIDS Control Organisation (NACO) guidelines. Patients (n=1221) with Hb >8gm/dl were prescribed AZT based ART regimen. Patients having anaemia (<8gm/dl) were excluded from the study. Correlation of baseline characteristics (age, sex, weight, Hb level, CD4 count, World Health Organization (WHO) clinical stage) with risk of developing anaemia was also calculated. 178 (14.6%) patients on AZT regimen developed anaemia. Patients with low CD4 count were more prone to develop severe anaemia. Age, sex, weight, WHO clinical stage had no relation with development of anaemia. Incidence of AZT induced anaemia was very high and patients having low CD4 count were more susceptible to develop anaemia.

Prevalence of HIV-related autoimmune haemolytic anaemia in Lagos, Nigeria.

Background:Despite a high frequency of anaemia, a positive direct antiglobulin test (DAT) and bone marrow hyperplasia HIV-infected patients, lack of reticulocytosis may cause underdiagnosis autoimmune haemolytic anaemia (AIHA) in them. This study was carried out to determine the prevalence of autoimmune haemolytic anaemia in HIV-infected patients and to compare the haematological/immunological characteristics of subjects with anaemia and those without.Materials and Methods:A total of 350 HIV-infected subjects attending the Lagos University Teaching Hospital who consented were recruited for the study. This included 250 subjects with anaemia (haemoglobin concentration <10 g/dl) as cases and 100 subjects without anaemia as controls. Five milliliters of venous blood drawn from each subject was used for the full blood count, reticulocyte count and DAT.Results:Subjects with anaemia had lower mean CD4 cell count (284.3 cells/μl) and higher mean reticulocyte per cent (1.5%) than the non-anaemic subjects. The frequency of reticulocytosis was higher in female subjects than in males. Only 0.8% (2 of 250) of the study group screened positive to DAT, p = 0.0339. None of the subjects in control group screened positive to DAT.Conclusion:Autoimmune haemolytic anaemia is a rare complication of HIV infection in our geographical location.

Seroepidemiological study of human parvovirus B19 among human immunodeficiency virus-infected patients in a medium-sized city in Rio de Janeiro, Brazil

Parvovirus B19 (B-19) may cause chronic anaemia in immunosuppressed patients, including those infected with human immunodeficiency virus (HIV). We studied single serum samples from 261 consecutive HIV-infected patients using an enzyme immunoassay to detect IgG antibodies to B-19. The seroprevalence of B-19-IgG was 62.8%. The differences in seroprevalence across gender, age, educational categories, year of collection of the serum samples, clinical and antiretroviral therapy characteristics, CD4+ count, CD4+ and CD8+ percentage and CD4+/CD8+ ratios were neither substantial nor statistically significant. There was a non-significant, inverse association between B-19 seropositivity and plasma HIV load and haemoglobin level. Our results indicated that 37.1% of patients might be susceptible to B-19 infection and remained at risk for being infected, mainly during epidemic periods. As B-19 infection can be treated with immune globulin preparations, it may be included in the diagnostic approach toward chronic anaemia in HIV-infected patients.

Achieving KDOQI Guidelines for Hematocrit in HIV-Infected Hemodialysis Patients

The primary cause of anemia in HIV-infected patients with ESRD is diminished production of erythropoietin. Although most patients respond to recombinant erythropoietin, the response may be blunted in patients with ESRD and concomitant viral or bacterial infections. Previous studies demonstrated a response to erythropoietin by HIV-infected ESRD patients, but hematocrit levels on average were only 27–29%. We were interested in determining if KDOQI guidelines could be met in these patients. Hematocrits and epogen doses of all HIV-positive patients who were undergoing hemodialysis at the Nassau University Medical Center Dialysis Unit between September 2002 and March 2003 were compared to matched controls in our hemodialysis unit. The hematocrit levels in our population were higher than those reported in earlier papers. In our patient population, the mean hematocrit was 37.5, whereas the mean hematocrit levels in the HIV group in previous papers were 27–29%. HIV-infected patients did require higher erythropoietin dosages than controls, but similar doses were used as compared to previous studies. HIV patients on hemodialysis can achieve KDOQI target hematocrits. The difference in route of iron administration and iron stores may explain the higher hematocrit levels in our HIV patient population as compared to previous trials.

Prevalence Of Anaemia In Hiv-Infected Patients At Arv Treatment Center, Abuth Zaria, Nigeria

Background: Anaemia in HIV-infected individuals has been known to be a common complication that correlates well with disease progression, patient survival and final outcome. Objective: To determine the prevalence of anaemia in HAART naïve patients at the Ahmadu Bello University Teaching Hospital (ABUTH), a designated national antiretroviral treatment center Methods: This is cross sectional descriptive study of HIV- patients receiving treatment at ABUTH treatment center from March 2002 to September 2005. Study process included documenting patients' bio-data, standardized medical history, hematocrit, reticulocyte counts, bone marrow aspirations and biopsy and CD4+T cell counts. Anaemia in this study was defined as hematocrit of less than 0.36L/L. Results were analysed using SPSS version 11 soft ware. Results: Out of 856 patients, 119 (13.9%) had anaemia. Median age of the patients was 34 yrs. Eighty (67.2%) were females while 39(32.8%) were males. Hematocrit levels ranged from 0.13-0.35L/L with a mean of 0.29L/L and SD of 0.48L/L in the anaemic patients and 0.37-0.44L/lLmean 39l/l +/-5 SD in the non-anaemic patients. Reticulocyte counts ranged from 2.8-12.3% (median 6.2%). CD4+ cell counts in all patients ranged from 40-1060 cells/ul, 49 (89.1%) of the anaemic patients had CD4 cell counts 350. Twenty one (15.9%) were in stages 1, 36 (26%) were in stage 2, 67 (48.5%) were in stage 3 and 13 (9.4%) were in stage 4 respectively. Type of anaemia based on morphology found 15.2% with dimorphic blood picture 33.4% with macrocytic picture while 51.4% had normocytic normpchromic blood picture. Conclusions: Anaemia is common in our patients and was more severe in advanced stages of the disease in patients with low CD4+T cell counts. Keywords: Haart, Hiv/Aids, Arv, AneamiaHighland Medical Research Journal Vol. 4 (2) 2006 pp. 27-31

Impact of Tuberculosis Co-Infection on the Level of PCV in HIV Infected Patients.

Background: It has been documented that HIV causes anemia in HIV infected patients. One of the commonest opportunistic infection in HIV patients is TB, and this has also been documented to cause anemia. In Nigeria, several cases of HIV and TB co-infections have been diagnosed. This study was carried out to determine any possible impact of TB co-infection on the level of HIV induced anemia. Methods: Anemia in this study was defined as PCV values below 30%. Three categories of subjects were recruited: 22 patients who had HIV infection only, 12 with HIV and co-infected with TB and 29 who are infected with TB only. A group of 10 apparently healthy subjects who were negative for HIV and TB were used as controls. These subjects were recruited from the Lagos University Teaching Hospital (LUTH), the Main land Hospital Yaba and the staff clinic of the Nigeria Institute of Medical Research all in Lagos, Nigeria . Blood samples were obtained from each of the enrolled subjects and the PCV levels were determined by the microhaematocrit method. All patients with TB diagnosis were sputum positive for AFB. CD4 cell count was determined for all HIV infected subjects using a FACScount. Results: PCV was significantly lower in all categories of subjects when compared with the control (0.05) from those co infected with HIV.Conclusion: Co-infection of HIV with TB did not worsen anemia in studied subjects. Keywords: HIV, Tuberculosis, Co-infection, Anemia.NQJHM Vol. 14 (2) 2004: pp. 115-117

Autoimmune hemolytic anemia in HIV-infected patients: A hospital based study

The prevalence of anemia in HIV/AIDS patients is high, with a multitude of possible etiologies; autoimmune hemolytic anemia (AIHA) in HIV/AIDS patients has been associated with a poor prognosis when treated with red cell transfusion. Our aim was to demonstrate the frequency of AIHA in a cohort of adult Nigerian HIV/AIDS patients and to see if the presence or not of AIHA is related to the severity of the disease with regards to the CD4 counts and the presence or absence of opportunistic infections. Ninety- eight adult patients with HIV infection were screened for the presence of AIHA using the packed cell volume (PCV), direct antiglobulin test (DAT) and reticulocyte count (RC). The frequency of AIHA was 3.06%, 36.74% of our study population were anemic; 11.22% had a positive DAT. Mean RC was 2.22 +/- 0.90 for all the patients. There was no statistically significant difference in the PCV of patients that had positive and negative DAT. There was no correlation between the presence of AIHA, use of ART, presence of opportunistic infections or CD4 counts. We conclude that in spite of the low frequency of AIHA in HIV/AIDS patients, the fact that most patients will respond to standard treatment makes it imperative to screen HIV/AIDS patients with anemia for the presence of AIHA. Again since HIV/A IDS patients with AIHA may have a fatal reaction to red cell transfusion, we suggest that anemic patients with HIV/AIDS in non -emergency situations be screened for the presence of AIHA before receiving red cell transfusions when indicated.