A proposal for basic management of HIV disease in West Africa: use of clinical staging and haemogram data

Ledru, Éric; Diagbouga, Serge; Méda, Nicolas; Sanou, P T; Dahourou, H; Ledru, Sylvie; Dembélé, A; Zoubga, A. Z.; Durand, Georges

doi:10.1258/0956462981922638

Cited by 14 publications

(12 citation statements)

References 13 publications

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“…In this study, we used haemoglobin as measure of anaemia. Haemoglobin measurement plays an important role in the basic management of HIV disease in West Africa [ 39 ] and could be measured easily where resources for more sophisticated laboratory markers are not available. For better monitoring and intervention, regular measurements could be of great help.…”

Section: Discussionmentioning

confidence: 99%

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

Obirikorang

Issahaku

Osakunor

et al. 2016

AIDS Research and Treatment

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Aim. We determined the prevalence of anaemia and evaluated markers of iron homeostasis in a cohort of HIV patients. Methods. A comparative cross-sectional study on 319 participants was carried out at the Tamale Teaching Hospital from July 2013 to December 2013, 219 patients on HAART (designated On-HAART) and 100 HAART-naive patients. Data gathered include sociodemography, clinical history, and selected laboratory assays. Results. Prevalence of anaemia was 23.8%. On-HAART participants had higher CD4/CD3 lymphocyte counts, Hb, HCT/PCV, MCV, MCH, iron, ferritin, and TSAT (P < 0.05). Hb, iron, ferritin, and TSAT decreased from grade 1 to grade 3 anaemia and CD4/CD3 lymphocyte count was lowest in grade 3 anaemia (P < 0.05). Iron (P = 0.0072) decreased with disease severity whilst transferrin (P = 0.0143) and TIBC (P = 0.0143) increased with disease severity. Seventy-six (23.8%) participants fulfilled the criteria for anaemia, 86 (26.9%) for iron deficiency, 41 (12.8%) for iron deficiency anaemia, and 17 (5.3%) for iron overload. The frequency of anaemia was higher amongst participants not on HAART (OR 2.6 for grade 1 anaemia; OR 3.0 for grade 3 anaemia). Conclusion. In this study population, HIV-associated anaemia is common and is related to HAART status and disease progression. HIV itself is the most important cause of anaemia and treatment of HIV should be a priority compared to iron supplementation.

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Section: Discussionmentioning

confidence: 99%

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

Obirikorang

Issahaku

Osakunor

et al. 2016

AIDS Research and Treatment

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“…Moore et al, (1998) found that treatment of anaemia with erythropoietin was associated with an improved prognosis possibly by allowing higher doses or prolonged use of drugs such as zidovudine and ganciclovir. In a recent cross-sectional study, haemoglobin measurement was shown to play an important role in the basic management of HIV disease in West Africa [41]. …”

Section: Discussionmentioning

confidence: 99%

Blood haemoglobin measurement as a predictive indicator for the progression of HIV/AIDS in resource-limited setting

Obirikorang

Yeboah

2009

J Biomed Sci

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BackgroundAnaemia is a frequent complication of infection with the human immunodeficiency virus (HIV) and may have multiple causes. The objective of this study was to find out if blood haemoglobin measurement could be used as an indicator for the progression of HIV/AIDS in resource-limited setting.MethodsTwo hundred and twenty-eight (228) consented People Living with HIV/AIDS (PLWHAs) who were placed in three groups according to their CD4 counts were used in the study. The three groups were those with CD4 counts (1) ≥ 500 mm-3; (2) 200-499 mm-3; and (3) <200 mm-3. One hundred (100) sex, age-matched and healthy HIV-seronegative individuals were used as control subjects. Blood haemoglobin, blood haematocrit, Red cell indices which included Mean Cell Volume, Mean Cell Haemoglobin Concentration and Mean Cell Haemoglobin and CD4 count were analysed in all subjects.ResultsThe mean blood haemoglobin concentrations in those with CD4 counts <200 mm-3, 200-499 mm-3 and ≥ 500 mm-3 (8.83 ± 0.22 g/dl, 10.03 ± 0.31 g/dl and 11.3 ± 0.44 g/dl respectively) were significantly lower when compared with the control group (14.29 ± 0.77 g/dl) (p < 0.0001). The mean blood haematocrit levels in those with CD4 counts <200 mm-3, 200-499 mm-3 and ≥ 500 mm-3 (23.53 ± 0.85%, 28.28 ± 0.77% and 33.54 ± 1.35% respectively) were also significantly lower when compared with the control group (41.15 ± 2.15%) (p < 0.0001). The red cell indices were also lower in the subjects when compared with the control group. Using the Pearson's correlation, there was a significant and positive correlation between the blood haemoglobin level and their CD4 counts (r2 = 0.1755; p < 0.0001).ConclusionAnaemia in People Living with HIV/AIDS, if persistent, is associated with substantially decreased survival. From our analysis, there was a decrease in the blood haemoglobin, levels as the HIV infection progressed and our findings are consistent with those of other studies of anaemia as a prognostic factor in HIV infection. Haemoglobin levels could be measured easily where resources for more sophisticated laboratory markers such as viral load or even CD4 lymphocyte count are not available given that measurement of the CD4 lymphocyte count requires flow cytometry, an expensive technique unavailable in many developing countries. Regular measurements could help to determine which patients are at greatest risk of disease progression, allowing these patients to be identified for closer monitoring or therapeutic intervention.

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“…A cross-sectional study of Hb measurements has consistently shown to play an important role in the basic management of HIV disease in West Africa [24,25,28,43].…”

Section: Similar Studies Bymentioning

confidence: 99%

Correlations Between Cluster Differentiation 4 Counts, Human Immunodeficiency Virus Clinical Stages, and Hemoglobin Level Among Human Immunodeficiency Virus Patients With Anemia in Merpati Clinic, Wangaya Hospital, Denpasar, Bali, Indonesia: A Cross-Secti

Suryana¹,

Suharsono

Budiasa³

et al. 2019

Asian J Pharm Clin Res

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Objective: The objective of this study was to determine the correlation between cluster of differentiation 4 (CD4) counts, human immunodeficiency virus (HIV) clinical stages, and hemoglobin (Hb) level among HIV-infected patients with anemia. Methods: A cross-sectional study was conducted in November 2017 at Merpati Clinic of Wangaya Hospital, Denpasar, Bali, Indonesia. We selected 79 HIV patients with anemia to participate in our study. We grouped CD4 counts into two categories: <200 cells/μL and ≥200 cells/μL, and we classified the HIV clinical stages into HIV and acquired immunodeficiency syndrome (AIDS). Results: About 55.7% (44) of men and 44.3% (35) of women were participated in this study. As many as, 91.1% (72) of participants were AIDS patients. The mean Hb was 8.77 g/dl with SD 1.79 g/dl. 81% (64) of study participants were suffered from anemia on chronic disease or inflammatory anemia, and 19% (15) of study participants were suffered from iron deficiency anemia. The median for CD4 counts was 94 cells/μL (3–309 cells/μL) with as many as 78.5% (62) of participants were found to have low CD4 counts (<200 cells/μL). Spearman analysis revealed a positive correlation between CD4 counts and Hb level (r=0.427, p<0.001). Independent sample t-test analysis found a correlation between the HIV clinical stages and Hb level. There was a difference between the mean of Hb level in each stage with the average difference of 0.8 g/dl (95% confidence interval 0.04–1.6; p<0.04). Conclusions: There is a correlation between CD4 counts, HIV clinical stages, and Hb level among HIV patients with anemia.

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A proposal for basic management of HIV disease in West Africa: use of clinical staging and haemogram data

Cited by 14 publications

References 13 publications

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

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

Blood haemoglobin measurement as a predictive indicator for the progression of HIV/AIDS in resource-limited setting

Correlations Between Cluster Differentiation 4 Counts, Human Immunodeficiency Virus Clinical Stages, and Hemoglobin Level Among Human Immunodeficiency Virus Patients With Anemia in Merpati Clinic, Wangaya Hospital, Denpasar, Bali, Indonesia: A Cross-Secti

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