Prospective Changes in Serum Levels of Some Proinflammatory Cytokines and Erythropoietin among Anaemic HIV-infected Patients Attending Kenyatta National Hospital Comprehensive Care Centre

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dc.contributor.authorIreri, Jackson
dc.contributor.authorNgeranwa, J.J.N.
dc.contributor.authorMburu, David
dc.contributor.authorJaoko, Walter
dc.contributor.authorSekadde-Kigondu, Christine
dc.contributor.authorWanzala, Peter
dc.date.accessioned2018-01-09T08:57:49Z
dc.date.available2018-01-09T08:57:49Z
dc.date.issued2017
dc.descriptionResearch Articleen_US
dc.description.abstractBetween 70 to 80% of HIV infected patients develop anaemia which is a major complication in advanced HIV infection. The multifactorial etiology of the HIV-associated anaemia requires extensive studies on its unique pathophysiology as a step towards improving therapeutic options and disease management.The objective of this study is to monitor changes in serum levels of erythropoietin (Epo), Tumor necrosis factor-alpha (TNF-α), Interleukin-6 (IL-6), C-Reactive Protein (CRP) and anaemia in HIV infected patients over six months’ period. This study is Longitudinal descriptive study and it was conducted at Kenyatta National Hospital, Kenyatta National Hospital can be considered as Comprehensive Care Centre. The study used one hundred and eighty-four (184) seropositive adults aged 18 to 60 years.The results shows that Blood cells exhibited pathologies ranging from: Rouleaux formation, round macrocytes, microcytic hypochromic cells and target cells in frequencies that decreased with increase in CD4+ cells. Normochromic, macrocytic normochromic and dimorphic anaemias were observed. Bicytopenia (erythrocytopenia and leucopenia), reactive thrombocytosis with giant platelets, neutrophil and eosinophil hypersegmentations were also observed. Persistent increase in Epo and CRP levels were demonstrated among subjects throughout the study period. Increases in TNF-α levels without corresponding increase in IL-6 levels were observed. Persistence anaemia in presence of high Epo levels is suggestive of hyposensitivity to Epo by erythroid precursors. Asynchronized increases in TNF-α and IL- 6 levels may have deprived the duo the synergy required to effectively inhibit Epo production further facilitating the escalating levels of Epo observed. High levels of CRP observed indicate enhanced inflammation processes associated with HIV infection. Iron studies to rule out the role of iron-restricted erythropoiesis in the development microcytic, dimorphic anaemias and the granulocytic hypersegmentations noted are recommended. Studies on the possibility of Epo hyposensitivity derailing the effectiveness of recombinant human Epo in the management of HIV – associated anaemia are recommended.en_US
dc.identifier.citationInternational Journal of Sciences: Basic and Applied Research (IJSBAR) (2017) Volume 36, No 8, pp 90-107en_US
dc.identifier.issn2307-4531
dc.identifier.urihttp://ir-library.ku.ac.ke/handle/123456789/18093
dc.language.isoenen_US
dc.publisherGlobal Society of Scientific Research and Researchersen_US
dc.subjectProinflamatory cytokinesen_US
dc.subjectErythropoietinen_US
dc.subjectAnaemiaen_US
dc.subjectHuman immunodeficiency Virusen_US
dc.titleProspective Changes in Serum Levels of Some Proinflammatory Cytokines and Erythropoietin among Anaemic HIV-infected Patients Attending Kenyatta National Hospital Comprehensive Care Centreen_US
dc.typeArticleen_US
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