Dadabhoy Institute of Higher Education, Karachi, Pakistan; Immunology and Infectious Diseases, Research Laboratory, Department of Microbiology, University of Karachi, Pakistan.
Dow University of Health Sciences, Karachi, Pakistan.
J Infect Public Health. 2018 Mar-Apr;11(2):250-254. doi: 10.1016/j.jiph.2017.07.027. Epub 2017 Aug 23.
Multiple infections are the most common problem among HIV infected individuals. The prognostic impact of these co infections in HIV-population in resource-limited countries like Pakistan has not been fully elucidated. The aim of this study was to assess CD4 and hemoglobin (Hb) levels in patients with HIV mono infection and HIV co-infection with Hepatitis C (HCV), Hepatitis B (HBV) and Mycobacterium tuberculosis (MTB).
A total of 207 HIV positive patients were assessed for CD4 cells count and hemoglobin levels after confirmation of HIV by rapid tests as well as PCR. CD4 counts were performed via flow cytometry whereas hemoglobin levels were performed by Sysmex K-4500 auto-analyzer.
Out of 207 patients, 22 patients were found to be HIV mono-infected, while 185 patients were HIV positive along with co-infections of MTB or HCV or HBV. We found significant positive correlation between HB levels and CD4 count across the studied group (r=0.30 in HIV mono-infected group, r=0.23 in HIV co-infected group, p<0.05) at baseline. However, majority of the low hemoglobin levels (<8g/dl) and low CD4 count (<200cells/ul) cases were observed particularly in HIV/TB co-infections.
This study documents the prognostic value of hemoglobin assessment in HIV patients. The results indicate that decreasing Hb levels correlate with decreasing CD4 counts. It is emphasizing that Hb measurement may be used as an inexpensive surrogate marker as compared to CD4 analysis for disease progression in HIV patients. In addition, low Hb levels may also indicate presence of under lying co-infections, particularly, with M. tuberculosis (MTB).
多重感染是 HIV 感染者最常见的问题。在资源有限的国家，如巴基斯坦，这些合并感染对 HIV 人群的预后影响尚未完全阐明。本研究旨在评估 HIV 单一感染和 HIV 合并感染丙型肝炎病毒（HCV）、乙型肝炎病毒（HBV）和结核分枝杆菌（MTB）的患者的 CD4 和血红蛋白（Hb）水平。
通过快速检测和 PCR 确认 HIV 阳性后，对 207 例 HIV 阳性患者进行 CD4 细胞计数和血红蛋白水平检测。CD4 计数通过流式细胞术进行，而血红蛋白水平通过 Sysmex K-4500 自动分析仪进行。
在 207 例患者中，发现 22 例为 HIV 单一感染，而 185 例为 HIV 阳性合并 MTB 或 HCV 或 HBV 感染。我们发现整个研究组中 HB 水平与 CD4 计数之间存在显著正相关（HIV 单一感染组 r=0.30，HIV 合并感染组 r=0.23，p<0.05）。然而，大多数低血红蛋白水平（<8g/dl）和低 CD4 计数（<200cells/ul）病例主要见于 HIV/TB 合并感染。
本研究记录了血红蛋白评估在 HIV 患者中的预后价值。结果表明，Hb 水平下降与 CD4 计数下降相关。这强调了与 CD4 分析相比，Hb 测量可能作为一种廉价的替代标志物用于 HIV 患者的疾病进展。此外，低 Hb 水平也可能表明存在潜在的合并感染，特别是与 M. tuberculosis（MTB）。
