» Articles » PMID: 35812431

Relationship Between Anemia and Systemic Inflammation in People Living With HIV and Tuberculosis: A Sub-Analysis of the CADIRIS Clinical Trial

Abstract

People with HIV (PWH) are at increased risk of developing active tuberculosis (TB), and anemia is a common complication in both conditions. Anemia in TB patients has been linked to immune activation, levels of inflammatory biomarkers in blood, and risk for HIV disease progression and death. In this study we show that anemia was associated with a more pronounced inflammatory profile in HIV-TB coinfected persons in a cohort of 159 individuals with advanced HIV disease (CD4 count < 100 cells/µL) recruited as part of a randomized clinical trial (NCT00988780). A panel of plasma biomarkers was assessed on plasma obtained prior to combination antiretroviral therapy (cART) initiation. We performed a series of multidimensional analyses including clinical variables and concentrations of inflammatory biomarkers to profile systemic inflammation of PWH with and without anemia. We observed that TB participants presented with moderately lower levels of hemoglobin than non-TB participants. These participants also presented a higher Degree of Inflammatory Perturbation (DIP) score, related to increased levels of IFN-γ and TNF. The DIP was associated with TB coinfection and anemia before cART initiation. Future mechanistic studies are warranted to assess the determinants of such associations and the implications on treatment outcomes.

Citing Articles

Sex differences in the risk profiles for anemia in people living with HIV, A cross sectional study.

Kamvuma K, Hamooya B, Chiyenu K, Ademola Y, Mudenda S, Machiko A PLoS One. 2025; 20(3):e0319611.

PMID: 40063574 PMC: 11892841. DOI: 10.1371/journal.pone.0319611.


Haematological markers as predictive tools for tuberculosis in PLHIV: a retrospective cohort study in Gujarat, India.

M Y, Vamja R, Parmar P, Makwana N, Sundar R BMC Infect Dis. 2025; 25(1):228.

PMID: 39962402 PMC: 11834239. DOI: 10.1186/s12879-025-10625-y.


Prevalence and factors associated with moderate-to-severe anaemia among virally suppressed people with HIV at a tertiary hospital in Zambia.

Kamvuma K, Masenga S, Hamooya B, Chanda W, Munsaka S PLoS One. 2024; 19(8):e0303734.

PMID: 39186572 PMC: 11346727. DOI: 10.1371/journal.pone.0303734.


Mechanisms and Cardiorenal Complications of Chronic Anemia in People with HIV.

Kamvuma K, Hamooya B, Munsaka S, Masenga S, Kirabo A Viruses. 2024; 16(4).

PMID: 38675885 PMC: 11053456. DOI: 10.3390/v16040542.


Effect of the relationship between anaemia and systemic inflammation on the risk of incident tuberculosis and death in people with advanced HIV: a sub-analysis of the REMEMBER trial.

Araujo-Pereira M, Krishnan S, Salgame P, Manabe Y, Hosseinipour M, Bisson G EClinicalMedicine. 2023; 60:102030.

PMID: 37287871 PMC: 10242630. DOI: 10.1016/j.eclinm.2023.102030.


References
1.
Patel N, Zhu J, Tachado S, Zhang J, Wan Z, Saukkonen J . HIV impairs TNF-alpha mediated macrophage apoptotic response to Mycobacterium tuberculosis. J Immunol. 2007; 179(10):6973-80. DOI: 10.4049/jimmunol.179.10.6973. View

2.
Vinhaes C, Sheikh V, Oliveira-de-Souza D, Wang J, Rupert A, Roby G . An Inflammatory Composite Score Predicts Mycobacterial Immune Reconstitution Inflammatory Syndrome in People with Advanced HIV: A Prospective International Cohort Study. J Infect Dis. 2020; 223(7):1275-1283. PMC: 8030712. DOI: 10.1093/infdis/jiaa484. View

3.
Sandler N, Wand H, Roque A, Law M, Nason M, Nixon D . Plasma levels of soluble CD14 independently predict mortality in HIV infection. J Infect Dis. 2011; 203(6):780-90. PMC: 3071127. DOI: 10.1093/infdis/jiq118. View

4.
Goncalves A, Lever M, Russo P, Gomes-Correia B, Urbanski A, Pollara G . Assessing the Impact of Sample Heterogeneity on Transcriptome Analysis of Human Diseases Using MDP Webtool. Front Genet. 2019; 10:971. PMC: 6822058. DOI: 10.3389/fgene.2019.00971. View

5.
Graham S, Chen J, Le J, Ling M, Chung D, Liles W . Von Willebrand Factor Adhesive Activity and ADAMTS13 Protease Activity in HIV-1-Infected Men. Int J Med Sci. 2019; 16(2):276-284. PMC: 6367531. DOI: 10.7150/ijms.28110. View