Sipsas N V, Kokori S I, Ioannidis J P, Kyriaki D, Tzioufas A G, Kordossis T
Department of Pathophysiology, Laikon General Hospital and School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
J Infect Dis. 1999 Dec;180(6):2044-7. doi: 10.1086/315156.
In a cohort of 204 unselected consecutive human immunodeficiency virus type 1 (HIV-1)-infected patients, the association of circulating autoantibodies to endogenous erythropoietin (EPO) with HIV-1-related anemia was studied. Circulating autoantibodies to EPO were present in 48 (23.5%) of the 204 patients studied. Circulating autoantibodies were an independent predictor of anemia (odds ratio [OR]=5.0; 95% confidence interval [CI], 2.5-9.9), as strong as other known causes of anemia. The association of anti-EPO antibodies with anemia became stronger when the analysis was limited to the group of patients without any medical condition causing anemia (OR=10.4; 95% CI, 3.2-33.9). Moreover, the effect on hemoglobin levels remained significant even after adjusting for other anemia parameters. Anti-EPO autoantibodies were associated with higher EPO levels (r=.25, P=.012) and with a more prominent EPO response to anemia. Our findings suggest that autoimmunity, among other factors, may contribute to the pathogenesis of HIV-1-related anemia.
在一组204例未经挑选的连续的1型人类免疫缺陷病毒（HIV-1）感染患者中，研究了循环中针对内源性促红细胞生成素（EPO）的自身抗体与HIV-1相关贫血之间的关联。在204例研究患者中，有48例（23.5%）存在循环中针对EPO的自身抗体。循环中自身抗体是贫血的独立预测因素（优势比[OR]=5.0；95%置信区间[CI]，2.5-9.9），与其他已知的贫血原因一样显著。当分析仅限于无任何导致贫血的疾病的患者组时，抗EPO抗体与贫血的关联更强（OR=10.4；95%CI，3.2-33.9）。此外，即使在调整了其他贫血参数后，对血红蛋白水平的影响仍然显著。抗EPO自身抗体与较高的EPO水平相关（r=0.25，P=0.012），并且与对贫血更显著的EPO反应相关。我们的研究结果表明，自身免疫以及其他因素可能在HIV-1相关贫血的发病机制中起作用。
