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Anaemia and Iron Homeostasis in a Cohort ofHIV-Infected

Patients: A Cross-Sectional Study in Ghana

Rangga Lunesia

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Introduction

• Anaemia – Iron defciency : leading cause o anaemia

in the

developing world – iron defciency anaemia :

• 3rd leading cause o Disability-Adusted Lie !ears"DAL!s# or ♀

• top $% disease burdens or&• severe public health problem or

children'pregnant women ( )* countries +

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• ,%$,: 3+3 mill people living with .I/ "0ub-0aharan Arica the mostheavily a1ected #

•  Anaemia : common eature o .I/ inection ",%2%4# and occurs in34 o patients who initiate .ighly Active Antiretroviral 5herapy".AAR5#+

• Anaemia at .AAR5 initiation associated with HIV diseaseprogression and mortality+

• 6oderate and severe anaemia were associated with an increasedmortality among 5an7anian women with .I/+ As HIV diseaseseverity progresses8 the lielihood of developing anaemiaincreases+

• 6icronutrient defciencies8 blood loss rom intestinal opportunisticdisease8 malaria8 598 and parasitic inections involved in thedevelopment o .I/-associated anaemia

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6ethodology

• Study Design/Site. – comparative cross-sectional

 – 0eually 5ransmitted Inections "05I# clinic o the 5amale 5eaching .ospital ;orthern Region o articipation was voluntary and written inormedconsent was obtained rom each+

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• Study Population. – all patients underwent ?baseline visit@ or a structured interview

and laboratory eaminations+

 – 3$ pats:• ,$ on .AAR5 "designated Bn-.AAR5#

• $%% .AAR5-naive pats "designated .AAR5-naive#+

 – Inclusion :• .I/-positive

• C $ yo

• ollowed up by the 5amale 5eaching .ospital 05I clinic on .AAR5 ( 3 months

• good adherence to therapy "missing , doses o 3% doses or 3 doses o )%doses#

 – Eclusion :• pregnant

• inFammation8"GR> ( +, mgHL#

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•  Data Collection and Laboratory Methods. – uestionnaire : data on sociodemography+

 – Glinical history rom pat med records+

 – mL early morning venous bloodJ , mL was dispensed into a vacutainertube containing ED5A8 3 mL was dispensed into a serum separator tube

"005#8 allowed to clot8 and then centriuged at 3%%% g or mins+ – AliKuots o the serum were stored at %MG until assays were perormed+

 – Laboratory assays : GDNHGD3 lymphocyte counts and haemoglobin andredHwhite cell indices

 – 0erum iron8 erritin8 transerrin8 and transerrin saturation "50A5#

 –

0erum GR> : to guide in e!cluding a rise in serum erritin due to acutein"ammation+

Data Analysis and Statistics. – Disease progression8 indicated by GDN "GDG#:

• 0tage $ "C%% cellsHmm3#

• 0tage ,",%%2N cellsHmm3#

• 0tage 3 ",%% cellsHmm3#

 – Disease progression "O.B# :•  mild ".b $%+2$,+ gHdL or menJ $%+2$$+ gHdL or

women#8

• moderate ".b +%2$%+N gHdL#8

• severe ".b +% gHdL#

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Results

• 0ignifcantly more emales than males on.AAR5"5able $#+

• Bn-.AAR5 patientss : signi#cantly higher

GDNHGD38 .b8 haematocrit8 6G/8 6G.8 RDO-0D8 serum iron8 erritin8 and transerrinsaturation than when compared to theircorresponding .AAR5-naPve group+

•

.owever8 O9G count8 serum transerrin8 and 5I9G were higher amongst the HAA$%-naivepats "5able ,#+

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