PMID- 36283285
OWN - NLM
STAT- MEDLINE
DCOM- 20221115
LR  - 20221115
IS  - 2352-3964 (Electronic)
IS  - 2352-3964 (Linking)
VI  - 85
DP  - 2022 Nov
TI  - Association between severe anaemia and inflammation, risk of IRIS and death in 
      persons with HIV: A multinational cohort study.
PG  - 104309
LID - S2352-3964(22)00491-1 [pii]
LID - 10.1016/j.ebiom.2022.104309 [doi]
LID - 104309
AB  - BACKGROUND: After initiating antiretroviral therapy (ART), approximately 25% of 
      people with HIV (PWH) may develop Immune Reconstitution Inflammatory Syndrome 
      (IRIS), which is associated with increased morbidity and mortality. Several 
      reports have demonstrated that low haemoglobin (Hb) levels are a risk factor for 
      IRIS. To what extent the severity of anaemia contributes to the risk of IRIS 
      and/or death is still insufficiently explored. METHODS: We investigated both the 
      presence and severity of anaemia in PWH in a multinational cohort of ART-na..ve 
      patients. A large panel of plasma biomarkers was measured pre-ART and patients 
      were followed up for 6 months. IRIS or deaths during this period were considered 
      as outcomes. We performed multidimensional analyses, logistic regression, and 
      survival curves to delineate associations. FINDINGS: Patients with severe anaemia 
      (SA) presented a distinct systemic inflammatory profile, characterized by higher 
      TNF, IL-6, and IL-27 levels. SA was independently associated with IRIS, with a 
      higher risk of both early IRIS onset and death. Among IRIS patients, those with 
      SA had a higher risk of mycobacterial IRIS. INTERPRETATION: PWH with SA display a 
      more pronounced inflammatory profile, with an elevated risk of developing IRIS 
      earlier and a statistically significant higher risk of death. FUNDING: Intramural 
      Research Program of National Institute of Allergy and Infectious 
      Diseases/National Institutes of Health (NIAID/NIH). Coordena....o de 
      Aperfei..oamento de Pessoal de N.ivel Superior (Finance code: 001) and the 
      Conselho Nacional de Desenvolvimento Cient.ifico e Tecnol..gico (CNPq), Brazil.
CI  - Copyright (c) 2022 The Author(s). Published by Elsevier B.V. All rights reserved.
FAU - Ara Jo-Pereira, Mariana
AU  - Ara Jo-Pereira M
AD  - Instituto Gon..alo Moniz, Funda....o Oswaldo Cruz, Salvador, Brazil; 
      Multinational Organization Network Sponsoring Translational and Epidemiological 
      Research (MONSTER) Initiative, Salvador, Brazil; Programa de P..s-Gradua....o em 
      Patologia Humana e Experimental, Universidade Federal da Bahia, Salvador, Bahia, 
      Brazil.
FAU - Sheikh, Virginia
AU  - Sheikh V
AD  - National Institutes of Allergy and Infectious Diseases, National Institutes of 
      Health, Bethesda, MD, USA.
FAU - Sereti, Irini
AU  - Sereti I
AD  - National Institutes of Allergy and Infectious Diseases, National Institutes of 
      Health, Bethesda, MD, USA.
FAU - Barreto-Duarte, Beatriz
AU  - Barreto-Duarte B
AD  - Instituto Gon..alo Moniz, Funda....o Oswaldo Cruz, Salvador, Brazil; 
      Multinational Organization Network Sponsoring Translational and Epidemiological 
      Research (MONSTER) Initiative, Salvador, Brazil; Programa de P..s-Gradua....o em 
      Cl.inica M..dica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; 
      Curso de Medicina, Universidade Salvador (UNIFACS), Salvador, Bahia, Brazil.
FAU - Arriaga, Mar Ia B
AU  - Arriaga MIB
AD  - Instituto Gon..alo Moniz, Funda....o Oswaldo Cruz, Salvador, Brazil; 
      Multinational Organization Network Sponsoring Translational and Epidemiological 
      Research (MONSTER) Initiative, Salvador, Brazil; Programa de P..s-Gradua....o em 
      Patologia Humana e Experimental, Universidade Federal da Bahia, Salvador, Bahia, 
      Brazil.
FAU - Tib Rcio, Rafael
AU  - Tib Rcio R
AD  - Instituto Gon..alo Moniz, Funda....o Oswaldo Cruz, Salvador, Brazil; 
      Multinational Organization Network Sponsoring Translational and Epidemiological 
      Research (MONSTER) Initiative, Salvador, Brazil; Programa de P..s-Gradua....o em 
      Patologia Humana e Experimental, Universidade Federal da Bahia, Salvador, Bahia, 
      Brazil.
FAU - Vinhaes, Caian L
AU  - Vinhaes CL
AD  - Instituto Gon..alo Moniz, Funda....o Oswaldo Cruz, Salvador, Brazil; 
      Multinational Organization Network Sponsoring Translational and Epidemiological 
      Research (MONSTER) Initiative, Salvador, Brazil; Bahiana School of Medicine and 
      Public Health, Bahia Foundation for the Development of Sciences, Salvador, 
      Brazil.
FAU - Pinto-de-Almeida, Manuella
AU  - Pinto-de-Almeida M
AD  - Multinational Organization Network Sponsoring Translational and Epidemiological 
      Research (MONSTER) Initiative, Salvador, Brazil; Curso de Medicina, Universidade 
      Salvador (UNIFACS), Salvador, Bahia, Brazil.
FAU - Wang, Jing
AU  - Wang J
AD  - Clinical Monitoring Research Program Directorate, Frederick National Laboratory 
      for Cancer Research, Frederick, MD, USA.
FAU - Rupert, Adam
AU  - Rupert A
AD  - National Institutes of Allergy and Infectious Diseases, National Institutes of 
      Health, Bethesda, MD, USA.
FAU - Roby, Gregg
AU  - Roby G
AD  - National Institutes of Allergy and Infectious Diseases, National Institutes of 
      Health, Bethesda, MD, USA.
FAU - Shaffer, Douglas
AU  - Shaffer D
AD  - Kenya Medical Research Institute, Henry Jackson Foundation Medical Research 
      International, Bethesda, MD, USA; Walter Reed Army Institute of Research/US Army 
      Medical Research Directorate-Africa, Nairobi, Kenya.
FAU - Ananworanich, Jintanat
AU  - Ananworanich J
AD  - South East Asia Research Collaboration with Hawaii, Henry M. Jackson Foundation 
      for the Advancement of Military Medicine, United States Military HIV Research 
      Program, Bethesda, MD, USA.
FAU - Phanuphak, Nittaya
AU  - Phanuphak N
AD  - SEARCH, Institute of HIV Research and Innovation, Bangkok, Thailand.
FAU - Sawe, Fred
AU  - Sawe F
AD  - Kenya Medical Research Institute, Henry Jackson Foundation Medical Research 
      International, Bethesda, MD, USA.
FAU - Andrade, Bruno B
AU  - Andrade BB
AD  - Instituto Gon..alo Moniz, Funda....o Oswaldo Cruz, Salvador, Brazil; 
      Multinational Organization Network Sponsoring Translational and Epidemiological 
      Research (MONSTER) Initiative, Salvador, Brazil; Programa de P..s-Gradua....o em 
      Patologia Humana e Experimental, Universidade Federal da Bahia, Salvador, Bahia, 
      Brazil; Programa de P..s-Gradua....o em Cl.inica M..dica, Universidade Federal do 
      Rio de Janeiro, Rio de Janeiro, Brazil; Curso de Medicina, Universidade Salvador 
      (UNIFACS), Salvador, Bahia, Brazil. Electronic address: bruno.andrade@fiocruz.br.
LA  - eng
PT  - Journal Article
DEP - 20221022
PL  - Netherlands
TA  - EBioMedicine
JT  - EBioMedicine
JID - 101647039
SB  - IM
MH  - Humans
MH  - Cohort Studies
MH  - *Immune Reconstitution Inflammatory Syndrome/etiology
MH  - *HIV Infections/complications/drug therapy
MH  - Inflammation/complications
MH  - *Anemia/complications
PMC - PMC9593179
OTO - NOTNLM
OT  - Death
OT  - HIV
OT  - IRIS
OT  - Systemic inflammation
OT  - Tuberculosis
COIS- Declaration of interests The authors declare that the research was conducted in 
      the absence of any commercial or financial relationships that could be construed 
      as a potential conflict of interest.
EDAT- 2022/10/26 06:00
MHDA- 2022/11/16 06:00
PMCR- 2022/10/22
CRDT- 2022/10/25 18:26
PHST- 2022/05/26 00:00 [received]
PHST- 2022/10/03 00:00 [revised]
PHST- 2022/10/04 00:00 [accepted]
PHST- 2022/10/26 06:00 [pubmed]
PHST- 2022/11/16 06:00 [medline]
PHST- 2022/10/25 18:26 [entrez]
PHST- 2022/10/22 00:00 [pmc-release]
AID - S2352-3964(22)00491-1 [pii]
AID - 104309 [pii]
AID - 10.1016/j.ebiom.2022.104309 [doi]
PST - ppublish
SO  - EBioMedicine. 2022 Nov;85:104309. doi: 10.1016/j.ebiom.2022.104309. Epub 2022 Oct 
      22.