Iron Studies of HIV-Infected Subjects in Calabar- A Nigerian Perspective

Abstract

Investigating anaemia through screening tests could be insufficient in managing chronic infections. This study investigated the involvement of iron in the anaemia of human immunodeficiency virus infection. Participants were aged 19 to 50 years, comprising 76 infected subjects and 53 controls. The CD4 + count and haemoglobin concentration were determined by automation. Serum iron and total iron binding capacity were determined colorimetrically, while serum ferritin and interleukin-6 were analyzed by enzyme linked immunosorbent assay. Percentage of treatment-naïve subjects (61%) exceeded that of subjects on treatment (39%). Generally, 12%, 16% and 8% of the infected subjects had lower serum iron, total iron binding capacity and ferritin values respectively while 50%, 51% and 35% had values higher than the reference values respectively. However 38%, 33% and 57% of the infected subjects had their values within the reference limits. Approximately 45% of infected subjects had lower haemoglobin concentration, while 55% had values within range. The iron parameters of treatment naïve infected subjects did not significantly (P> 0.05) change when compared with those on treatment but significantly changed (P < 0.5) when compared with the control group. Degree of immunosuppression adjudged by the CD4 + count was 31.5% for severe 48.7% advanced, 14.5% mild and only 5.3% normal. There are greater percentages of treatment naive subjects as well as severe immunosuppression in this locality. Approximately 45% anaemia prevalence was recorded in the studied infected population but the anaemia may not be a reflection of iron deficiency.

Prevalence of Anaemia after Initiation of Antiretroviral Therapy among HIV-infected Patients Attending University of Calabar Teaching Hospital Calabar, Nigeria

“…Anaemia is one of the common findings among persons living with HIV infection as also reported in studies from Calabar, Nigeria [6,8]. However, the presence of anaemia in HIV infection even after commencement of treatment is an observation that warrants investigation of both demographic and biomedical features of this type of anaemia.…”

“…Apart from having this broad overview, studies also seek to identify the prevailing features that infected persons present with, which sometimes differ on the basis of quite a number of demographic issues such as race, gender, age and socio-economic status. Some of the striking observations about anaemia of HIV include the loss of iron balance which has been noted as a significant complication in HIV infection [5,6], while for those on therapy, the occurrence of anaemia has been associated with use of zidovudine.…”

“…Meanwhile in developing societies including Nigeria where nutritional deficiencies persist, anaemia on its own is yet to be effectively controlled and different vulnerable groups are being identified particularly women of childbearing age and children. It may therefore not be surprising that anaemia constitutes a major health challenge for people living with HIV infection in a country like Nigeria [6][7][8]. The anaemia occurring in HIV infection appears to be ameliorated by antiretroviral therapy, yet significant proportions of anaemic subjects are found among those who have commenced therapy [7][8][9][10].…”

Reduced P53 Protein Level and Evidence of Ongoing Coagulation among HIV-Infected Persons Accessing Treatment at University of Calabar Teaching Hospital, Nigeria

“…Unfortunately, the conventional antenatal care is yet to be fully accessed with the result that some infected pregnant women are not detected on time and the risk of vertical transmission continues to be a challenge [2]. Thus, late presentation to hospital remains a militating factor to early intervention [3]. Among the infected persons in our local population, widespread derangement in biomarkers and morbidity indicators that mirror poor health status prevail [4].…”