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Association between severe anaemia and inflammation, risk of IRIS and death in persons with HIV: A multinational cohort study

  1. Author:
    Araújo-Pereira, Mariana
    Sheikh, Virginia
    Sereti, Irini
    Barreto-Duarte, Beatriz
    Arriaga, María B
    Tibúrcio, Rafael
    Vinhaes, Caian L
    Pinto-de-Almeida, Manuella
    Wang,Jing
    Rupert, Adam
    Roby, Gregg
    Shaffer, Douglas
    Ananworanich, Jintanat
    Phanuphak, Nittaya
    Sawe, Fred
    Andrade, Bruno B

  2. Author Address

    1Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil; Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Brazil; Programa de Pós-Graduação em Patologia Humana e Experimental, Universidade Federal da Bahia, Salvador, Bahia, Brazil. 2National Institutes of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA. 3Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil; Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Brazil; Programa de Pós-Graduação em Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Curso de Medicina, Universidade Salvador (UNIFACS), Salvador, Bahia, Brazil. 4Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil; Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Brazil; Bahiana School of Medicine and Public Health, Bahia Foundation for the Development of Sciences, Salvador, Brazil. 5Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Brazil; Curso de Medicina, Universidade Salvador (UNIFACS), Salvador, Bahia, Brazil. 6Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick, MD, USA. 7Kenya Medical Research Institute, Henry Jackson Foundation Medical Research International, Bethesda, MD, USA; Walter Reed Army Institute of Research/US Army Medical Research Directorate-Africa, Nairobi, Kenya. 8South East Asia Research Collaboration with Hawaii, Henry M. Jackson Foundation for the Advancement of Military Medicine, United States Military HIV Research Program, Bethesda, MD, USA. 9SEARCH, Institute of HIV Research and Innovation, Bangkok, Thailand. 10Kenya Medical Research Institute, Henry Jackson Foundation Medical Research International, Bethesda, MD, USA. 11Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil; Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, Brazil; Programa de Pós-Graduação em Patologia Humana e Experimental, Universidade Federal da Bahia, Salvador, Bahia, Brazil; Programa de Pós-Graduação em Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Curso de Medicina, Universidade Salvador (UNIFACS), Salvador, Bahia, Brazil. Electronic address: bruno.andrade@fiocruz.br.
    1. Year: 2022
    2. Date: Oct 22
    3. Epub Date: 2022 10 22
  2. Journal: EBioMedicine
    1. 85
    2. Pages: 104309
  4. Type of Article: Article
  5. Article Number: 104309
  1. Abstract:

    After initiating antiretroviral therapy (ART), approximately 25% of people with HIV (PWH) may develop Immune Reconstitution Inflammatory Syndrome (IRIS), which is associated with increased morbidity and mortality. Several reports have demonstrated that low haemoglobin (Hb) levels are a risk factor for IRIS. To what extent the severity of anaemia contributes to the risk of IRIS and/or death is still insufficiently explored. We investigated both the presence and severity of anaemia in PWH in a multinational cohort of ART-naïve patients. A large panel of plasma biomarkers was measured pre-ART and patients were followed up for 6 months. IRIS or deaths during this period were considered as outcomes. We performed multidimensional analyses, logistic regression, and survival curves to delineate associations. Patients with severe anaemia (SA) presented a distinct systemic inflammatory profile, characterized by higher TNF, IL-6, and IL-27 levels. SA was independently associated with IRIS, with a higher risk of both early IRIS onset and death. Among IRIS patients, those with SA had a higher risk of mycobacterial IRIS. PWH with SA display a more pronounced inflammatory profile, with an elevated risk of developing IRIS earlier and a statistically significant higher risk of death. Intramural Research Program of National Institute of Allergy and Infectious Diseases/National Institutes of Health (NIAID/NIH). Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Finance code: 001) and the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil. Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.

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External Sources

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  2. DOI: 10.1016/j.ebiom.2022.104309
  3. PMID: 36283285
  4. PMCID: PMC9593179
  5. PII : S2352-3964(22)00491-1

Library Notes

  1. Fiscal Year: FY2022-2023
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