expand Hiv and H.B and what are they
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Explanation:
HIV :- HUMAN IMMUNO VIRUS
HB :- HINDUSTAN BRAINLY
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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.
Methods
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.
Results
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).
Conclusion
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.
Background
HIV infection is the chief cause of morbidity and mortality among adults and children, especially in sub-Saharan Africa. At the end of 2007, 40 million persons worldwide were living with HIV or AIDS [1]. Anaemia is a frequent complication that occurs in 20-80% of HIV-infected persons and is associated with faster disease progression and mortality [2]. This makes it more common than thrombocytopenia or leucopenia in patients with AIDS [3]. Therefore, interventions to prevent anaemia may lead to improved health and survival potential of HIV-infected persons [4].
HIV infection may lead to anemia in many ways: changes in cytokine production with subsequent effects on hematopoiesis [5,6] decreased erythropoietin concentrations [7] opportunistic infectious agents, such as Mycobacterium avium complex [8] and parvovirus B- [9] administration of chemotherapeutic agents such as zidovudine, ganciclovir, [10] and trimethoprimsulfamethoxazole [11] and myelophthisis caused by cancers such as lymphosarcoma. Other mechanisms for HIV-associated anaemia, although uncommon, include vitamin B12 deficiency [12] and the autoimmune destruction of red blood cells[13]. Anaemia has been associated with progression to AIDS and shorter survival times[14] for HIV-infected patients.
While CD4 count and HIV-RNA are the gold standard markers for disease monitoring in PLWHAs, when measurement of these parameters is not possible surrogate markers become important. Markers investigated for their utility as simple markers for disease progression in resource-limited settings include delayed type hypersensitivity responses (DTH), total lymphocyte count (TLC), haemoglobin and body mass index (BMI) [15]
The aim of this study was, therefore, to determine if blood haemoglobin measurement could be used as an indicator for the progression of HIV/AIDS in limited resource-limited settings. We sought to compare the change in haemoglobin levels in the patients as the disease progressed to a Control group who were one hundred (100) sex- and age-matched healthy, HIV-seronegative individuals. In addition, we sought to investigate the relationship between haemoglobin and CD4 lymphocyte count in the HIV individuals.