Blood haemoglobin measurement as a predictive indicator for the progression of HIV/AIDS in resource-limited setting.
Blood haemoglobin measurement as a predictive indicator for the progression of HIV/AIDS in resource-limited setting.
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DOI：
10.1186/1423-0127-16-102
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发表时间：
2009-11-18
影响因子：
11
通讯作者：
Yeboah FA
中科院分区：
文献类型：
--
作者：
Obirikorang C;Yeboah FA
贫血是人类免疫缺陷病毒（HIV）感染的常见并发症，可能有多种原因。本研究的目的是找出血液血红蛋白测量是否可以作为一个指标，艾滋病毒/艾滋病的进展，在资源有限的设置。研究中使用了228名同意的艾滋病毒/艾滋病感染者（PLWHA），根据其CD4计数将其分为三组。三组为CD4计数（1）≥ 500 mm-3;（2）200 - 499 mm-3;和（3）<200 mm-3的患者。将100名性别、年龄匹配的健康HIV血清阴性个体用作对照受试者。分析所有受试者的血红蛋白、血红细胞压积、红细胞指数（包括平均细胞体积、平均细胞血红蛋白浓度和平均细胞血红蛋白）和CD4计数。CD4计数<200 mm-3、200 - 499 mm-3和≥ 500 mm-3的患者的平均血红蛋白浓度（8.83 ± 0.22 g/dl，10.03 ± 0.31 g/dl和11.3 ± 0.44 g/dl）显著低于对照组（14.29 ± 0.77 g/dl）（p <0.0001）。与对照组（41.15 ± 2.15%）相比，CD4计数<200 mm-3、200 - 499 mm-3和≥ 500 mm-3的患者的平均血液红细胞压积水平（分别为23.53 ± 0.85%、28.28 ± 0.77%和33.54 ± 1.35%）也显著降低（p <0.0001）。与对照组相比，受试者的红细胞指数也较低。使用Pearson相关性，血液血红蛋白水平与其CD4计数之间存在显著的正相关（r2 = 0.1755; p <0.0001）。艾滋病毒/艾滋病感染者的贫血如果持续存在，会大大降低存活率。根据我们的分析，随着艾滋病毒感染的进展，血液血红蛋白水平下降，我们的研究结果与其他关于贫血作为艾滋病毒感染预后因素的研究结果一致。在病毒载量或甚至CD4淋巴细胞计数等更复杂的实验室标记物资源缺乏的情况下，血红蛋白水平可以很容易地测量，因为测量CD4淋巴细胞计数需要流式细胞术，而这是一种昂贵的技术，许多发展中国家都没有。定期测量可以帮助确定哪些患者处于疾病进展的最大风险，从而可以识别这些患者进行更密切的监测或治疗干预。
Anaemia 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. Two 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. The 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). Anaemia 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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