Adewumi A Adediran, Titilope A Adeyemo, Osamuedemen V Aghayere, Vincent O Osunkalu, Akinsegun A Akinbami, Dapus O Damulak, Sulaimon A Akanmu
Department of Haematology and Blood Transfusion, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria.
Niger Med J. 2014 Jan;55(1):63-6. doi: 10.4103/0300-1652.128175.
Despite a high frequency of anaemia, a positive direct antiglobulin test (DAT) and bone marrow hyperplasia HIV-infected patients, lack of reticulocytosis may cause underdiagnosis autoimmune haemolytic anaemia (AIHA) in them. This study was carried out to determine the prevalence of autoimmune haemolytic anaemia in HIV-infected patients and to compare the haematological/immunological characteristics of subjects with anaemia and those without.
A total of 350 HIV-infected subjects attending the Lagos University Teaching Hospital who consented were recruited for the study. This included 250 subjects with anaemia (haemoglobin concentration <10 g/dl) as cases and 100 subjects without anaemia as controls. Five milliliters of venous blood drawn from each subject was used for the full blood count, reticulocyte count and DAT.
Subjects with anaemia had lower mean CD4 cell count (284.3 cells/μl) and higher mean reticulocyte per cent (1.5%) than the non-anaemic subjects. The frequency of reticulocytosis was higher in female subjects than in males. Only 0.8% (2 of 250) of the study group screened positive to DAT, p = 0.0339. None of the subjects in control group screened positive to DAT.
Autoimmune haemolytic anaemia is a rare complication of HIV infection in our geographical location.
尽管贫血、直接抗人球蛋白试验（DAT）阳性及骨髓增生在HIV感染患者中很常见，但网织红细胞增多症的缺乏可能导致这些患者的自身免疫性溶血性贫血（AIHA）诊断不足。本研究旨在确定HIV感染患者中自身免疫性溶血性贫血的患病率，并比较贫血患者和非贫血患者的血液学/免疫学特征。
共有350名自愿参加拉各斯大学教学医院研究的HIV感染受试者被纳入研究。其中包括250名贫血患者（血红蛋白浓度<10 g/dl）作为病例组，100名非贫血患者作为对照组。从每个受试者采集5毫升静脉血用于全血细胞计数、网织红细胞计数和DAT检测。
贫血患者的平均CD4细胞计数（284.3个/μl）低于非贫血患者，平均网织红细胞百分比（1.5%）高于非贫血患者。女性受试者中网织红细胞增多症的发生率高于男性。研究组中仅0.8%（250例中的2例）DAT检测呈阳性，p = 0.0339。对照组中无一例DAT检测呈阳性。
在我们所处的地理位置，自身免疫性溶血性贫血是HIV感染的一种罕见并发症。
