Redig Amanda J, Berliner Nancy
1Department of Medicine, and.
Hematology Am Soc Hematol Educ Program. 2013;2013:377-81. doi: 10.1182/asheducation-2013.1.377.
Anemia is a common feature of HIV-related disease and has been uniformly demonstrated to be an independent predictor of morbidity and mortality. Although anemia often responds to combination antiretroviral therapy, many patients remain anemic despite therapy and such persistent anemia continues to negatively affect prognosis regardless of drug response. Anemia is also a common feature of normal aging. We postulate that the pathophysiology of anemia in HIV, especially that which persists in the face of combination antiretroviral therapy, is a reflection of underlying proinflammatory pathways that are also thought to contribute to anemia in the elderly, as well as other age-related chronic diseases such as cardiovascular disease and chronic obstructive pulmonary disease. This suggests that HIV induces inflammatory pathways that are associated with a pattern of accelerated aging and that anemia is a biomarker of these processes. A better understanding of the pathophysiology of HIV-related anemia may provide important entry points for improving the chronic manifestations of HIV-related disease.
贫血是HIV相关疾病的常见特征，并且一直被证实是发病率和死亡率的独立预测因素。尽管贫血通常对抗逆转录病毒联合疗法有反应，但许多患者在治疗后仍会贫血，而且这种持续性贫血无论药物反应如何，都会继续对预后产生负面影响。贫血也是正常衰老的常见特征。我们推测，HIV患者贫血的病理生理学，尤其是在接受抗逆转录病毒联合疗法后仍持续存在的贫血，反映了潜在的促炎途径，这些途径也被认为与老年人贫血以及其他与年龄相关的慢性疾病（如心血管疾病和慢性阻塞性肺疾病）有关。这表明HIV诱导了与加速衰老模式相关的炎症途径，而贫血是这些过程的生物标志物。更好地理解HIV相关贫血的病理生理学可能为改善HIV相关疾病的慢性表现提供重要切入点。
