Circulating antibodies to endogenous erythropoietin and risk for HIV-1-related anemia
Accepted 18 December 2009. published online 14 January 2010.
Summary
Objectives
In a previous retrospective study we have shown that circulating antibodies to endogenous erythropoietin (anti-EPO) are associated with HIV-1-related anemia. The present longitudinal cohort study was conducted to examine the effect of anti-EPO on the risk of developing anemia over time.
Methods
The study population consisted of 113 HIV-1 seropositive patients, who were screened for the presence of anti-EPO, with a mean±SD follow up of 105±40 months, for a total of 2190 visits. Anti-EPO were detected with an ELISA assay.
Results
Anti-EPO were detected in 41% (46/113) at enrollment and 29% (320/1094) for all visits, and were associated with higher EPO levels for all visits (45.7±60.4 vs. 31.8±31.7IU/ml, p<0.001). After adjusting for other significant confounders, anti-EPO has been associated with increased risk of anemia both at enrollment (odds ratio [OR], 5.07; 95% confidence interval [CI], 1.25–20.49) as well as for all visits ([OR], 2.15; 95% [CI]: 1.29–3.56). During follow up, a decline in prevalence of both anti-EPO and anemia was observed as the percentage of patients receiving HAART was increasing.
Conclusions
Anti-EPO are an independent risk factor for anemia in HIV-1-infected patients. HAART seems to reduce both anti-EPO and anemia prevalence.
ABSTRACT