G6PD Deficiency in an HIV Clinic Setting in the Dominican Republic

Abstract

Abstract. Because human immunodeficiency virus (HIV)-infected patients receive prophylaxis with oxidative drugs, those with glucose-6-phosphate dehydrogenase (G6PD) deficiency may experience hemolysis. However, G6PD deficiency has not been studied in the Dominican Republic, where many individuals have African ancestry. Our objective was to determine the prevalence of G6PD deficiency in Dominican HIV-infected patients and to attempt to develop a cost-effective algorithm for identifying such individuals. To this end, histories, chart reviews, and G6PD testing were performed for 238 consecutive HIV-infected adult clinic patients. The overall prevalence of G6PD deficiency (8.8%) was similar in males (9.3%) and females (8.5%), and higher in Haitians (18%) than Dominicans (6.4%; P = 0.01). By logistic regression, three clinical variables predicted G6PD status: maternal country of birth (P = 0.01) and a history of hemolysis (P = 0.01) or severe anemia (P = 0.03). Using these criteria, an algorithm was developed, in which a patient subset was identified that would benefit most from G6PD screening, yielding a sensitivity of 94.7% and a specificity of 97.2%, increasing the pretest probability (8.8-15.1%), and halving the number of patients needing testing. This algorithm may provide a cost-effective strategy for improving care in resource-limited settings.

Donor glucose-6-phosphate dehydrogenase deficiency decreases blood quality for transfusion

“…G6PD activity was measured by a Clinical Laboratory Improvement Amendments-certified (CLIA-certified) reference laboratory (Associated Regional and University Pathologists Laboratories). All 13 exons of the G6PD gene of G6PD-deficient volunteers were analyzed by next-generation sequencing in the CLIA-certified Personalized Genomics Laboratory at Columbia University Irving Medical Center, New York, New York, to identify the specific G6PD variant present (64).…”

Molecular Characterization of Glucose-6-Phosphate Dehydrogenase: Do Single Nucleotide Polymorphisms Affect Hematological Parameters in HIV-Positive Patients?

“…In this study, among the participants with G6PD deficiency, we found 19.2% to harbor the G6PD A - allele (G202/A376), which is associated with the reduced enzyme activity [ 15 ]. A study by Xu et al in the Dominican Republic also reported a similarly high prevalence of the G6PD A - variant among HIV-infected patients [ 36 ]. Of note, we also observed that, among those with G6PD deficiency based on the methemoglobin reductase technique, 30.8% presented with no band on electrophoresis.…”

Should We Care About Plasmodium Vivax and HIV Coinfection? A Systematic Review and a Cases Series From the Brazilian Amazon

“…The prevalence of G6PD de ciency is relevant to both HIV and malaria. Despite HIV infection and antiretroviral therapy (ART) are both associated, separately and together, with increased oxidative stress, the impact of G6PD de ciency on the oxidative stress of people living with HIV (PLHIV) on ART is controversial [59][60][61] . PLHIV have signi cantly lower levels of antioxidants, hematology parameters, and CD4 + cells in comparison to healthy subjects; nonetheless, PLHIV on ART have presented higher level of antioxidants compared to ART naïve subjects 62 .…”