Anaemia is Associated with Monocyte Activation in HIV-Infected Adults on Antiretroviral Therapy

Lipshultz, Hannah; Hileman, Corrilynn Olesky; Ahuja, Sanjay P.; Funderburg, Nicholas T.; McComsey, Grace A.

doi:10.3851/imp2940

Cited by 8 publications

(8 citation statements)

References 26 publications

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“…In the general population, anemia has been characterized as a risk factor for MI and HF. 910 Among PLHIV, anemia also has been shown to relate to accelerated HIV disease progression and increased systemic immune activation/inflammation, 111213 of relevance to HIV-associated CVD. Suppression of endogenous testosterone production may contribute to anemia among transgender women with HIV.…”

Section: Research Lettermentioning

confidence: 99%

Cardiovascular Risk Profile of Transgender Women With HIV: A US Health Care Database Study

Gogia

Coromilas

Regan

et al. 2018

JAIDS Journal of Acquired Immune Deficiency Syndromes

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We sought to characterize the cardiovascular disease (CVD) risk factor profile of transgender women with HIV identified through a U.S. healthcare database. Compared with age- and race-matched cisgender men with HIV, transgender women with HIV had an increased prevalence of anemia and lower absolute hemoglobin levels. HIV control was sub-optimal and prevalence of HCV co-infection was high among transgender women. Further study of non-traditional CVD risk factors/immune activation among transgender women with HIV is warranted.

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Section: Research Lettermentioning

confidence: 99%

Cardiovascular Risk Profile of Transgender Women With HIV: A US Health Care Database Study

Gogia

Coromilas

Regan

et al. 2018

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…In fact, prevalence of anemia among HIV-infected patients is high [ 3 , 6 ] and it is frequently resolved after cART initiation [ 23 , 24 ]. Sometimes, however, anemia can persist in HIV-chronically-infected patients, even after HIV replication was suppressed with cART, and it has been associated with elevated levels of IL-6, CRP and D-dimer [ 3 ] and with monocyte activation [ 25 ]. This condition is considered as anemia of chronic inflammation.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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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.Electronic supplementary materialThe online version of this article (10.1186/s12967-017-1358-6) contains supplementary material, which is available to authorized users.

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“…Moreover, Kerkhoff et al found that the serum level of IL-6 was associated with the severity of ACD in patients with HIV and tuberculosis 20. In contrast, Lipshultz et al (2015) reported that IL-6 was not an independent predictor of anemia and mild anemia in HIV patients with cARV therapy 21. However, a study with fewer participants has concluded that serum IL-6 did not show significant correlation with anemia on PLWH on cARV therapy 22…”

Section: Discussionmentioning

confidence: 99%

<p>High levels of serum IL-6 and serum hepcidin and low CD4 cell count were risk factors of anemia of chronic disease in HIV patients on the combination of antiretroviral therapy</p>

Somia

Merati

Bakta

et al. 2019

HIV

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Purpose: This study aimed to determine whether high levels of serum IL-6 and serum hepcidin and CD4<350 cells/ul were risk factors for the anemia of chronic disease (ACD) in HIV-infected patients on the combination of antiretroviral (cARV) therapy with successful clinically and immunological responses. Patients and Methods: A matched case–control study was conducted in the VCT clinic of Sanglah General Hospital, Indonesia, between January 1 and September 1, 2016. The case group was HIV patients with ACD, while the control group was HIV patients without ACD. Purposive consecutive sampling was employed in HIV patients aged 15–65 years who have received cARV therapy for >6 months, had >95% adherence of cARV within 6 months, did not have any clinical failure, did not have any immunological failure and did not receive switch therapy within 6 months. Chi-square test and logistic regression analysis were performed. Results: A total of 42 cases and 42 controls were included in this study. Significant differences were found between case and control, which included serum IL-6, serum hepcidin, smoking, creatinine clearance, anemia at the initiation of cARV, CD4 at the initiation of cARV and actual CD4 (cell/µL). High levels of serum IL-6, high levels of serum hepcidin and CD4< 350 cells/µl were risk factors for ACD. After adjusted with anemia at cARV initiation and BMI, we found that high levels of serum IL-6 (adjusted OR: 17.682; 95% CI: 3.442–90.826), high levels of serum hepcidin (adjusted OR: 10.562; 95% CI: 2.531–44.076) and CD4 <350 cells/µl (adjusted OR: 4.181; 95% CI: 5.6–12.381) remain as risk factors for ACD. Conclusion: High levels of serum IL-6, high levels of serum hepcidin and CD4 count <350 cells/µL were risk factors for ACD in HIV patients with cARV therapy.

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Anaemia is Associated with Monocyte Activation in HIV-Infected Adults on Antiretroviral Therapy

Cited by 8 publications

References 26 publications

Cardiovascular Risk Profile of Transgender Women With HIV: A US Health Care Database Study

Cardiovascular Risk Profile of Transgender Women With HIV: A US Health Care Database Study

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

<p>High levels of serum IL-6 and serum hepcidin and low CD4 cell count were risk factors of anemia of chronic disease in HIV patients on the combination of antiretroviral therapy</p>

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