TY - JOUR
T1 - Neonatal erythropoiesis and subsequent anemia in HIV-positive and HIV-negative Zimbabwean babies during the first year of life
T2 - A longitudinal study
AU - Miller, Melissa F.
AU - Humphrey, Jean H.
AU - Iliff, Peter J.
AU - Malaba, Lucie C.
AU - Mbuya, Nkosinathi V.
AU - Chidawanyika, Henry
AU - Mahomva, Agnes
AU - Majo, Florence
AU - Marinda, Edmore
AU - Mbizvo, Michael
AU - Moulton, Lawrence Hale
AU - Mutasa, Kuda
AU - Ndhlovu, Mary
AU - Ntozini, Robert
AU - Piwoz, Ellen
AU - Propper, Maria Lidia de Moura
AU - Rambanepasi, Philipa
AU - Ruff, Andrea
AU - Tavengwa, Naume
AU - Ward, Brian
AU - Zijenah, Lynn
AU - Zunguza, Claire
AU - Zvandasara, Partson
AU - Nathoo, Kusum
AU - Humphrey, Jean
AU - Stoltzfus, Rebecca J.
PY - 2006/1/3
Y1 - 2006/1/3
N2 - 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. Results: At one year of age, HIV-positive infants were 5.26 (adjusted odds ratio, P<0.001) times more likely to be anemic compared to HIV-negative infants. Among, HIV-negative infants, EPO was or tended to be inversely associated with hemoglobin and was significantly positively associated with TfR throughout the first 6 months of life; TfR was significantly inversely associated with ferritin at 6 months; and EPO explained more of the variability in TfR than did ferritin. Among infected infants, the inverse association of EPO to hemoglobin was attenuated during early infancy, but significant at 6 months. Similar to HIV-negative infants, EPO was significantly positively associated with TfR throughout the first 6 months of life. However, the inverse association between TfR and ferritin observed among HIV-negative infants at 6 months was not observed among infected infants. Between birth and 6 months, mean serum ferritin concentration declined sharply (by ∼90%) in all three groups of babies, but was significantly higher among HIV-positive compared to HIV-negative babies at all time points. Conclusions: HIV strongly increases anemia risk and confounds interpretation of hematologic indicators in infants. Among HIV-infected infants, the EPO response to anemia is attenuated near the time of infection in the first weeks of life, but normalizes by 6 months.
AB - 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. Results: At one year of age, HIV-positive infants were 5.26 (adjusted odds ratio, P<0.001) times more likely to be anemic compared to HIV-negative infants. Among, HIV-negative infants, EPO was or tended to be inversely associated with hemoglobin and was significantly positively associated with TfR throughout the first 6 months of life; TfR was significantly inversely associated with ferritin at 6 months; and EPO explained more of the variability in TfR than did ferritin. Among infected infants, the inverse association of EPO to hemoglobin was attenuated during early infancy, but significant at 6 months. Similar to HIV-negative infants, EPO was significantly positively associated with TfR throughout the first 6 months of life. However, the inverse association between TfR and ferritin observed among HIV-negative infants at 6 months was not observed among infected infants. Between birth and 6 months, mean serum ferritin concentration declined sharply (by ∼90%) in all three groups of babies, but was significantly higher among HIV-positive compared to HIV-negative babies at all time points. Conclusions: HIV strongly increases anemia risk and confounds interpretation of hematologic indicators in infants. Among HIV-infected infants, the EPO response to anemia is attenuated near the time of infection in the first weeks of life, but normalizes by 6 months.
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U2 - 10.1186/1471-2334-6-1
DO - 10.1186/1471-2334-6-1
M3 - Article
C2 - 16390553
AN - SCOPUS:30544431748
SN - 1471-2334
VL - 6
JO - BMC infectious diseases
JF - BMC infectious diseases
M1 - 1
ER -