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pathophysiology of anemia in hiv

Collins Odhiambo, Clement Zeh, Pascale Ondoa, Paul Omolo, Benta Akoth, Humphrey Lwamba, Richard Lando, John Williamson, Juliana Otieno, Rose Masaba, Paul Weidle, Timothy Thomas
BACKGROUND: Anemia results in increased morbidity and mortality, underscoring the need to better understand its pathophysiology amongst HIV-exposed and infected children in sub-Saharan Africa, the region where most infant HIV exposure and infections occur. METHODS: This analysis used samples obtained from children in the Kisumu Breastfeeding Study (KiBS). KiBS was a longitudinal phase IIB, open-label, one-arm clinical trial, designed to investigate the safety, tolerability and effectiveness of a maternal triple-antiretroviral (ARV) regimen for prevention of mother-to-child transmission (PMTCT) of HIV, during late pregnancy and early infancy while breastfeeding...
2015: PloS One
Sharise T Richardson, Ashley L Franklin, Ellen S Rome, Judith S Simms-Cendan
Urogenital schistosomiasis affects millions of women in sub-Saharan Africa. Infection by the causative organism, Schistosoma hematobium, commonly occurs during childhood and adolescence and can lead to anemia from hematuria, inflammation on the cervix which can increase risk of HIV transmission, and pelvic infection leading to infertility. Fortunately treatment is not costly, but early diagnosis is important to reduce long-term morbidity. Our objective is to review the epidemiology, pathophysiology, and diagnosis of urogenital schistosomiasis as well as treatment to improve the reproductive health of girls where this infection is endemic...
August 2016: Journal of Pediatric and Adolescent Gynecology
Véronique Frémeaux-Bacchi
Hemolytic Uremic Syndrome (HUS) is characterized by the triad of hemolytic anemia, thrombocytopenia and acute renal failure. The most frequent form in children is caused by Shiga-toxin producing Escherichia coli. In absence of Shiga-toxin infection, the HUS is called atypical (aHUS). Some HUS are secondary to Streptococcus pneumonia or human immunodeficiency virus infection, cancer, anti-cancer drugs, or cyclosporine. During the last decade, aHUS has been demonstrated to be a disorder of complement alternative pathway regulation...
2013: Biologie Aujourd'hui
Amanda J Redig, Nancy Berliner
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...
2013: Hematology—the Education Program of the American Society of Hematology
Leonardo Rodrigues de Oliveira, Thaís Camargos Ferreira, Fernando de Freitas Neves, Antônio Carlos de Oliveira Meneses
Aplastic anemia is a bone marrow failure syndrome characterized by peripheral cytopenias and hypocellular bone marrow. Although aplastic anemia is idiopathic in most cases, rheumatic diseases such as systemic lupus erythematosus are recognized as causes of aplastic anemia, with their possible etiological mechanisms being T and B lymphocyte dysfunction and pro-inflammatory cytokines and autoantibody production directed against bone marrow components. In the course of the human immunodeficiency virus infection/acquired immunodeficiency syndrome, the identification of autoantibodies and the occurrence of rheumatic events, in addition to the natural course of systemic lupus erythematosus which is modified by immune changes that are characteristic of human immunodeficiency virus infection/acquired immunodeficiency syndrome, make the diagnosis of systemic lupus erythematosus challenging...
2013: Revista Brasileira de Hematologia e Hemoterapia
C Chidiac
Streptococcus pneumoniae is an important bacterium in humans, and is a cause of upper and lower respiratory tract infections, meningitis, bacteremia, and/or invasive infections. An analysis of literature allows identifying the main risk factors; spleen dysfunctions, sickle cell anemia, alcohol abuse, chronic liver disease, cirrhosis, ischemic cardiac diseases, congestive cardiac failure, diabetes mellitus, obesity, chronic lung disease, immunodeficient patients including HIV infection, and old age. S. pneumoniae infections are more frequent and more severe in these patients...
October 2012: Médecine et Maladies Infectieuses
Neha Mehta, Ashish Saxena, Ruben Niesvizky
Thrombotic thrombocytopaenic purpura (TTP) is a thrombotic microangiopathy characterised by haemolytic anaemia, schistocytes on peripheral blood smear and thrombocytopaenia that can additionally present with fever, renal insufficiency and/or neurological abnormalities. While our understanding of idiopathic TTP has significantly advanced, there are still many unanswered questions regarding the pathophysiology of secondary TTP, which can be associated with malignancy, pregnancy, HIV infection, bone marrow transplantation and exposure to certain drugs including several chemotherapeutic agents...
2012: BMJ Case Reports
P Szturz, M Moulis, Z Adam, R Slaisová, R Koukalová, Z Rehák, P Volfová, R Hájek, J Mayer
BACKGROUNDS: Castleman disease is a rare non-clonal lymphoproliferative disorder with the etiopathogenesis not yet thoroughly clarified. Clinically, either unicentric (localized) or multicentric (generalized) forms are recognized while, histopathologically, hyaline-vascular, plasma-cell and mixed variants of the disease exist. These types vary one from another in their clinical courses and, importantly, in methods of therapeutic management. While the unicentric hyaline-vascular form usually manifests as benign growth of a single lymph node and treatment response to complete surgical excision reaches up to 100%, the multicentric plasmocellular variant is an aggressive disease with generalized symptoms, laboratory abnormalities and the need for systemic therapy...
2011: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
Raja Gangopadhyay, Mahantesh Karoshi, Louis Keith
Anemia is a global public health problem. It has serious short- and long-term consequences during pregnancy and beyond. The anemic condition is often worsened by the presence of other chronic diseases such as malaria, tuberculosis, HIV, and diabetes. Untreated anemia also leads to increased morbidity and mortality from these chronic conditions as well. It is surprising that despite these chronic conditions (such as malaria, tuberculosis, and HIV) often being preventable, they still pose a real threat to public health...
November 2011: International Journal of Gynaecology and Obstetrics
Gary J Vanasse, Nancy Berliner
Anemia is a significant problem in elderly patients. Although many anemic elderly patients can be diagnosed with nutritional deficiency, anemia of chronic inflammation or comorbid diseases that explain their decreased hematocrit, the etiology of anemia in a significant fraction remains obscure. There is evidence to suggest that the hematopoietic stem cell displays increasing erythropoietin (EPO) resistance with age. EPO levels rise in elderly, nonanemic patients, and it is hypothesized that there is an interplay between this rising demand for EPO and the decreasing ability of the aging kidney to produce adequate hormone to meet that need...
2010: Hematology—the Education Program of the American Society of Hematology
Job C J Calis, Kamija S Phiri, Raymond J W M Vet, Rob J de Haan, Francis Munthali, Robert J Kraaijenhagen, Paul J M Hulshof, Malcolm E Molyneux, Bernard J Brabin, Michaël Boele van Hensbroek, Imelda Bates
Anemia is common in HIV infection, but the pathophysiology is poorly understood. Bone marrow analysis in 329 severely anemic (hemoglobin <5 g/dl) Malawian children with (n = 40) and without (n = 289) HIV infection showed that HIV-infected children had fewer CD34(+) hematopoietic progenitors (median 10 vs. 15‰, P = 0.04) and erythroid progenitors (2.2 vs. 3.4‰, P = 0.05), but there were no differences in erythrocyte viability and maturation in later stages of erythropoiesis. Despite an HIV-associated reduction in early red cell precursors, subsequent erythropoiesis appears to proceed similarly in HIV-infected and HIV-uninfected children with severe anemia...
November 27, 2010: AIDS
Yara A Park, Shauna N Hay, Mark E Brecher
BACKGROUND: Thrombotic microangiopathy (TMA) encompasses a number of disorders with hemolytic anemia and thrombocytopenia, including thrombotic thrombocytopenic purpura (TTP). A deficiency in ADAMTS13 enzyme levels, along with an inhibitory antibody, is found in most patients with idiopathic TTP. Patients with human immunodeficiency virus (HIV) infection can have a TTP-like illness; however, it appears to have a different etiology. METHODS: A retrospective review of patients who had an ADAMTS13 activity level performed from 2005 through 2007 was completed...
2009: Journal of Clinical Apheresis
Chigozie J Uneke
Plasmodium falciparum infections of the placenta remain a major medical challenge among pregnant women in sub-Saharan Africa. A number of factors influence the prevalence of placental malaria in pregnant women, including maternal age, gravidity, use of prophylaxis, nutrition, host genetics, and level of anti-parasite immunity, as well as parasite genetics and transmission rates [1]. Maternal anemia has been shown to be one of the major complications of placental malaria in sub-Saharan Africa. The mechanisms by which malaria causes anemia are fairly well understood...
March 2008: Yale Journal of Biology and Medicine
Zakari Y Aliyu, Gregory J Kato, James Taylor, Aliyu Babadoko, Aisha I Mamman, Victor R Gordeuk, Mark T Gladwin
Secondary pulmonary hypertension (PAH) has been shown to have a prevalence of 30% in patients with sickle cell disease (SCD) with mortality rates of 40% at 40 months after diagnosis in the United States. The burden of SCD is highest in sub-Saharan Africa, especially in Nigeria (West Africa), where approximately 6 million people are afflicted. The true global incidence, prevalence, and burden of SCD and its associated end organ complications however remain unknown. Chronic hemolysis represents a prominent mechanistic pathway in the pathogenesis of SCD-associated pulmonary hypertension via a nitric oxide (NO) scavenging and abrogation of NO salutatory effects on vascular function, including smooth muscle relaxation, downregulation of endothelial adhesion molecules and inhibition of platelet activation...
January 2008: American Journal of Hematology
Silvia Ferrari, Friedrich Scheiflinger, Manfred Rieger, Geert Mudde, Martine Wolf, Paul Coppo, Jean-Pierre Girma, Elie Azoulay, Christian Brun-Buisson, Fadi Fakhouri, Jean-Paul Mira, Eric Oksenhendler, Pascale Poullin, Eric Rondeau, Nicolas Schleinitz, Benoit Schlemmer, Jean-Louis Teboul, Philippe Vanhille, Jean-Paul Vernant, Dominique Meyer, Agnès Veyradier
To study both the pathophysiologic and the prognostic value of ADAMTS13 in thrombotic microangiopathies (TMAs), we enrolled a cohort of 35 adult patients combining a first acute episode of TMA, an undetectable (below 5%) ADAMTS13 activity in plasma, and no clinical background such as sepsis, cancer, HIV, and transplantation. All patients were treated by steroids and plasma exchange, and an 18-month follow-up was scheduled. Remission was obtained in 32 patients (91.4%), and 3 patients died (8.6%) after the first attack...
April 1, 2007: Blood
Melissa F Miller, Jean H Humphrey, Peter J Iliff, Lucie C Malaba, Nkosinathi V Mbuya, Rebecca J Stoltzfus
BACKGROUND: Anemia is common in HIV infection and independently associated with disease progression and mortality. The pathophysiology of HIV-related anemia is not well understood especially in infancy. METHODS: We conducted a longitudinal cohort study nested within the Zimbabwe Vitamin A for Mothers and Babies Project. We measured hemoglobin, erythropoietin (EPO), serum transferrin receptor (TfR) and serum ferritin at 6 weeks, 3 and 6 months of age and hemoglobin at 9 and 12 months in 3 groups of randomly selected infants: 136 born to HIV-negative mothers, and 99 born to HIV-positive mothers and who were infected themselves by 6 weeks of age, and 324 born to HIV-positive mothers but who did not become infected in the 6 months following birth...
2006: BMC Infectious Diseases
Ken Campbell
Anaemia is a common condition in which all forms can be defined on the basis of physiological mechanisms. There are three broad categories: decreased/defective red blood cell production; increased loss/destruction of red blood cells; and a mixture where both mechanisms operate simultaneously.
November 23, 2004: Nursing Times
Ellen Butensky, Christine M Kennedy, Marion M Lee, Paul Harmatz, Christine Miaskowski
Recently, anemia associated with human immunodeficiency virus (HIV) disease has received more attention as our understanding of the significance of anemia in this population has grown and more emphasis is placed on the quality of life of people living with HIV/AIDS. Although the diagnosis and treatment of anemia in HIV disease has been discussed in great detail, the prevalence and pathophysiology of the two most common forms of anemia, iron deficiency anemia (IDA) and the anemia of chronic disease (ACD), have not received much attention despite the difficulty and importance of differentiating between these two anemias...
November 2004: Journal of the Association of Nurses in AIDS Care: JANAC
Hans von Baeyer
The objective of this paper is to assess the role of plasmapheresis in immune hematology by reviewing published clinical outcome data and narrative review articles. This information will be used to define evidence levels for appraisal of the efficacy and rank of plasmapheresis among other management options. This evidence-based strategy conforms to the concepts of the American Society of Hematology (ASH). as put forward in 1996 in the context of immune thrombocytopenia (ITP) treatment. The term 'experimental' is used to describe indications where the only scientific evidence of the efficacy of plasmapheresis consists of pathophysiological reasoning and empiric clinical findings...
February 2003: Therapeutic Apheresis and Dialysis
Chadi Nabhan, Hau C Kwaan
Thrombotic thrombocytopenic purpura is a multisystem disease characterized by thrombocytopenia, hemolytic anemia, renal failure, fever, and neurologic abnormalities. Plasma exchange has revolutionized the outcome of this entity from a once fatal disease to a disease that potentially is cured or has prolonged remission. The understanding of the pathophysiology of TTP continues to evolve. Recently, investigators showed that a deficiency in a specific plasma protease responsible for cleaving vWf plays a crucial role in the familial form of TTP...
February 2003: Hematology/oncology Clinics of North America
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