Persistent anaemia and unresolved systemic dysfunction among persons living with HIV infection in Southern Nigeria

Anaemia in human immunodeficiency virus (HIV) infection has remained a significant morbidity indicator affecting both disease progression and outcome. Its persistence despite antiretroviral therapy continues to generate interest. Reports of systemic dysfunction in association with HIV has necessitated exploring possible systemic indices for assessment and monitoring of the infection. In resource-poor settings such as the study locality, identifying affordable biomarkers for disease management is important. This study was a case-control analytical single-site research among people living with HIV in Southern Nigeria. Purposive sampling technique was used to enrol equal numbers of newly diagnosed HIV-infected persons, patients on antiretroviral therapy and control subjects. Clinical considerations were duly obtained. Red cell parameters and CD4 count were assessed by automation. Aminotransferase enzyme activities were assayed by standard colorimetric methods. De Ritis ratio was calculated. The RBC, Hb and HCT were significantly reduced in HIV subjects on HAART compared to those newly diagnosed and control subjects. Both MCV, RDW-SD and De Ritis ratio were high in newly diagnosed subjects compared to HIV subjects on HAART and control subjects, while the CD4 count varied significantly across all three groups. There were significant moderate negative correlations between De Ritis ratio and both mean cell volume and mean cell haemoglobin. Overall systemic state rather than the index of immune response correlated with indices of anaemia among persons living with HIV infection and receiving antiretroviral therapy.