Anaemia and Iron Homeostasis in a Cohort of HIV-Infected Patients: A Cross-Sectional Study in Ghana

Obirikorang, Christian; Issahaku, Gyesi Razak; Osakunor, Derick Nii Mensah; Osei-Yeboah, James

doi:10.1155/2016/1623094

Cited by 28 publications

(36 citation statements)

References 34 publications

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“…HIV itself is a cause of anaemia. Iron deficiency anaemia is common but other factors that may also contribute to the development of anemia in HIV infected patients includes nutritional deficiencies, infections, AIDSrelated malignancies, drug treatment and a direct effect of HIV on the bone marrow [3][4][5]. HIV infects CD4 T-lymphocytes, monocytes and macrophages resulting in decreased number and function of CD4 cells, changes that affect both cell mediated and humoral immunity [3].…”

Section: Introductionmentioning

confidence: 99%

Serum iron, Folate, Ferritin and CD4 Count in HIV Seropositive Women

et al. 2016

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HIV infects cluster of differentiation 4 (CD4) T-lymphocytes, monocytes and macrophages resulting in decreased number and function of CD4 cells, changes that affect both cell mediated and humoral immunity. Hematological abnormalities are a common complication of human immune virus (HIV) infection and these abnormalities increase as the disease advances. Anemia is the most common haematological abnormality in HIV seropositive patients and its incidence is strongly associated with the progression of the disease. The aim of present study was to assess the haematological profile of HIV seropositive women and compare them with CD4 count. Two hundred seropositive females (age 18-25 years) attending antiretroviral therapy clinic were selected. Routine gynaecological and haematological investigations were carried out, study samples were drawn and serum iron, folate and ferritin were analysed by chemiluminiscence and CD4 count was determined by using flow-cytometry. Anemia was prevalent in seropositive women especially in those with low CD4 levels. Serum folate and ferritin levels were significantly lower in females with lower CD4 levels. Serum iron levels were higher at low CD4 levels. The mean CD4 count in HIV seropositive anaemic women were lower as compared to non anaemics suggesting that anaemia improves with higher CD4 cell counts. Plasma folate and ferritin levels are sensitive predictor of anaemia in early HIV infections and these patients should have a regular monitoring of their folate and ferritin levels especially with lower CD4 levels.

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Section: Introductionmentioning

confidence: 99%

Serum iron, Folate, Ferritin and CD4 Count in HIV Seropositive Women

et al. 2016

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“…A lower prevalence rate of 23% has been recently reported from Ghana [7]. The observed differences in these prevalence rates may be attributed to various factors like study area, study population, nutrition and the HAART regimen used as suggested by other workers [7,24]. In other words, socio-economic and demographic effects may have contributed to the observed differences.…”

Section: Discussionmentioning

confidence: 79%

“…However, higher prevalence rates of 60.61% and 64.0% were observed in Benin City, South-south, Nigeria [23] and in Keffi Northcentral, Nigeria [24] respectively. A lower prevalence rate of 23% has been recently reported from Ghana [7]. The observed differences in these prevalence rates may be attributed to various factors like study area, study population, nutrition and the HAART regimen used as suggested by other workers [7,24].…”

Section: Discussionmentioning

confidence: 81%

“…Also, a comparative cross sectional study in Ghana, postulated that anaemia in HIV infection was as a result of the virus itself more than HAART related [7]. Anaemia has been found in both naïve and HAART HIV patients suggesting that HIV may have caused defective physiologic activities thus impaired haematopoiesis [8].A HAART known as Zidovudine has been reported to cause anaemia in people living with HIV by causing intoxication of the bone marrow and marked decrease in haemoglobin concentration [9][10][11].…”

Section: Background Of Studymentioning

confidence: 99%

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Anaemia and Pro-inflammatory Cytokines in Human Immunodeficiency Virus Infection

Enumah¹,

Nwauche²,

Okerengwo³

2016

IJI

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Abstract:Anaemia is often seen in HIV infected individuals and cytokines imbalance have been reported to cause haematopoietic stem cells suppression in the bone marrow. This case control study was carried out to determine any possible correlation between haemoglobin and pro-inflammatory cytokines in the development of anaemia in people living with HIV. 54 HIV infected and 34 apparently healthy HIV uninfected individuals were enrolled in this study. Full blood count and levels of three pro-inflammatory cytokines [(IL-α (interleukin-1 alpha), TNF-α (tumour necrosis factor-alpha) and IFN-γ (interferon-gamma)] were determined using MindrayBC-6800 automated Haematology analyser and Enzyme linked Immunosorbent Assay (ELISA) kits (Aviva system Biology, San Diego, CA, USA) respectively. The results obtained showed that prevalence of anaemia was 40.7% in HIV infected subjects, with higher prevalence in females (54.5%) than in males (19.0%). The difference in the mean concentrations of haemoglobin, red blood cell, packed cell volume, IL-α and TNF-α was statistically significant (p<0.05) while white blood cell counts and IFN-γ were not statistically significant (p>0.05) when compared to the control group. Though, there was a higher level of IFN-γ in HIV infected group than in the control group. There were weak correlations between haematological parameters and pro-inflammatory cytokines in the HIV positive group. HIV subjects were later divided into treatment groups: those on highly active antiretroviral therapy (HAART) -ZidovudineLamuvidine-Nevirapine (ZLN) combination, Tenofovir-Lamuvidine-Efavirenz (TLE) combination and those that are not on HAART-treatment naïve patients (TNP). There were statistically significant differences in the mean concentrations of red blood cell and white blood cell across the TLE and TNP groups (p<0.05). There were positive correlations between IFN-γ and HB in TLE group but negative correlations in other two groups. Also, there were positive correlations between IFN-γ and WBC in ZLN group but negative correlations in other two groups. This study suggests that the dysregulated pro-inflammatory cytokine levels caused by HIV itself played a role in causing anaemia in HIV infections.

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“…The reference limits to haematological data were: MCV, 80-96 fL; MCH 27-33 pg; MCHC, 32-36 as pointers; low MCV (< 80 fL) was indicative of microcytosis; high MCV (> 96 fL) was indicative of macrocytosis; low MCH (< 27 pg) indicates hypochromia. (19) For iron intake evaluation, a semi-quantitative, retrospective FFQ was applied, recording the patient dietary intake through the last month prior to the nutritional visit. The FFQ was validated for Brazilian population based on National Study of Family Expenses.…”

Section: Methodsmentioning

confidence: 99%

Iron intake is positively associated with viral load in antiretroviral naïve Brazilian men living with HIV

Gonçalves

Silva

Roma

et al. 2019

Mem. Inst. Oswaldo Cruz

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BACKGROUND Iron homeostasis contribute for the human immunodeficiency virus (HIV) pathogenesis. OBJECTIVES We assessed the iron intake pattern in antiretroviral naïve Brazilian men living with HIV correlating with clinical and nutritional parameters. METHODSThe iron consumption mean was estimated according to a food frequency questionnaire (FFQ), and a 3-day food record (3dFR) submitted to the patients. HIV viral load, CD4 + T cell counts, serum iron, haematological and anthropometrics parameters were recorded.FINDINGS Fifty-one HIV-infected adult men naïve for antiretroviral therapy (ART) were enrolled. The mean age of participants was 35 (SEM ± 1.28) years old, with mean time of HIV-1 infection of 1.78 (0-16.36, min-max) years. Majority (41.18%) had complete secondary, and 21.57% had tertiary educational level. The income was around 1x (54.90%) to 2x (41.18%) minimum wage. Fifty-four percent showed normal weight, while 40% were overweight. The patients showed normal mean values of haematological parameters, and mean serum iron was 14.40 µM (SEM ± 0.83). The FFQ showed moderate correlation with the 3dFR (ρ = 0.5436, p = 0.0009), and the mean values of iron intake were 10.55(± 0.92) mg/day, recorded by FFQ, and 15.75(± 1.51) mg/day, recorded by 3dFR. The iron intake, recorded by FFQ, negatively correlated with serum iron (ρ = -0.3448, p = 0.0132), and did not have influence in the CD4 + T cell counts [e.B 0.99 (0.97-1.01, 95% confidence interval (CI), p = 0.2]. However, the iron intake showed a positive effect in HIV viral load [e.B 1.12 (1.02-1.25, 95%CI), p < 0.01].MAIN CONCLUSIONS This study draws attention for the importance of iron intake nutritional counseling in people living with HIV. However, more studies are required to clarify the association between high iron intake and HIV infection and outcome.

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Anaemia and Iron Homeostasis in a Cohort of HIV-Infected Patients: A Cross-Sectional Study in Ghana

Cited by 28 publications

References 34 publications

Serum iron, Folate, Ferritin and CD4 Count in HIV Seropositive Women

Serum iron, Folate, Ferritin and CD4 Count in HIV Seropositive Women

Anaemia and Pro-inflammatory Cytokines in Human Immunodeficiency Virus Infection

Iron intake is positively associated with viral load in antiretroviral naïve Brazilian men living with HIV

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