循环内源性促红细胞生成素抗体与 HIV-1 相关贫血的风险。

Circulating antibodies to endogenous erythropoietin and risk for HIV-1-related anemia.

机构信息

Department of Pathophysiology, National and Kapodistrian University of Athens, Greece.

出版信息

J Infect. 2010 Mar;60(3):238-43. doi: 10.1016/j.jinf.2009.12.013. Epub 2009 Dec 29.

DOI:10.1016/j.jinf.2009.12.013

PMID:20036688

Abstract

OBJECTIVES

In a previous retrospective study we have shown that circulating antibodies to endogenous erythropoietin (anti-EPO) are associated with HIV-1-related anemia. The present longitudinal cohort study was conducted to examine the effect of anti-EPO on the risk of developing anemia over time.

METHODS

The study population consisted of 113 HIV-1 seropositive patients, who were screened for the presence of anti-EPO, with a mean+/-SD follow up of 105+/-40 months, for a total of 2190 visits. Anti-EPO were detected with an ELISA assay.

RESULTS

Anti-EPO were detected in 41% (46/113) at enrollment and 29% (320/1094) for all visits, and were associated with higher EPO levels for all visits (45.7+/-60.4 vs. 31.8+/-31.7 IU/ml, p<0.001). After adjusting for other significant confounders, anti-EPO has been associated with increased risk of anemia both at enrollment (odds ratio [OR], 5.07; 95% confidence interval [CI], 1.25-20.49) as well as for all visits ([OR], 2.15; 95% [CI]: 1.29-3.56). During follow up, a decline in prevalence of both anti-EPO and anemia was observed as the percentage of patients receiving HAART was increasing.

CONCLUSIONS

Anti-EPO are an independent risk factor for anemia in HIV-1-infected patients. HAART seems to reduce both anti-EPO and anemia prevalence.

摘要

目的

在之前的回顾性研究中，我们已经表明内源性促红细胞生成素（EPO）的循环抗体（抗 EPO）与 HIV-1 相关贫血有关。本纵向队列研究旨在研究抗 EPO 随时间推移对贫血发生风险的影响。

方法

研究人群包括 113 名 HIV-1 血清阳性患者，他们接受了抗 EPO 的检测，平均随访时间为 105+/-40 个月，共 2190 次就诊。抗 EPO 采用 ELISA 检测。

结果

41%（46/113）的患者在入组时和 29%（320/1094）的所有就诊时检测到抗 EPO，并且所有就诊时的 EPO 水平均较高（45.7+/-60.4 vs. 31.8+/-31.7 IU/ml，p<0.001）。在调整了其他重要混杂因素后，抗 EPO 与入组时（比值比[OR]，5.07；95%置信区间[CI]，1.25-20.49）和所有就诊时（OR，2.15；95% CI：1.29-3.56）贫血的风险增加相关。在随访期间，随着接受 HAART 的患者比例增加，抗 EPO 和贫血的患病率均呈下降趋势。