Research Article
Impact of HIV Infection and Zidovudine Therapy on RBC
Parameters and Urine Methylmalonic Acid Levels
Adewumi Adediran,
1
Vincent Osunkalu,
1
Tamunomieibi Wakama,
2
Sarah John-Olabode,
1
Akinsegun Akinbami,
3
Ebele Uche,
3
and Sulaimon Akanmu
1
1
Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos, Idi-Araba, Lagos 100254, Nigeria
2
Department of Haematology and Blood Transfusion, National Hospital, Abuja 900241, Nigeria
3
Department of Haematology and Blood Transfusion, Lagos State University Teaching Hospital, Ikeja, Lagos 100271, Nigeria
Correspondence should be addressed to Adewumi Adediran; adediranadewumi@yahoo.com
Received 29 September 2015; Revised 5 January 2016; Accepted 13 January 2016
Academic Editor: Sandro Cinti
Copyright © 2016 Adewumi Adediran et al. Tis is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Background. Anaemia is a common complication of human immunodefciency virus (HIV) infection. Te aim of this study was
to investigate the impact of HIV infection and zidovudine on red blood cells (RBC) parameters and urine methylmalonic acid
(UMMA) levels in patients with HIV infection. Material and Methods. A cross-sectional study involving 114 subjects, 94 of which are
HIV-infected nonanaemic and 20 HIV negative subjects (Cg) as control. Full blood count parameters and urine methylmalonic acid
(UMMA) level of each subject were determined. Associations were determined by Chi-square test and logistic regression statistics
where appropriate. Results. Subjects on zidovudine-based ART had mean MCV (93 fL) higher than that of control group (82.9 fL)
and ART-na¨ ıve (85.9fL) subjects and the highest mean RDW. Mean UMMA level, which refects vitamin B12 level status, was
high in all HIV-infected groups but was signifcantly higher in ART-na¨ ıve subjects than in ART-experienced subjects. Conclusion.
Although non-zidovudine therapy may be associated with macrocytosis (MCV > 95 fL), zidovudine therapy and ART naivety may
not. Suboptimal level of vitamin B12 as measured by high UMMA though highest in ART-na¨ ıve subjects was common in all HIV-
infected subjects.
1. Introduction
Anaemia is the most common haematological complication
of HIV infection. Prevalence of anaemia in HIV infection
varies from 1.3% to 95% [1–3].
Tough the World Health Organization (WHO) defnes
anaemia as a haemoglobin concentration of <13 g/dL for men
and <12 g/dL for nonpregnant women, haemoglobin cut of
of <10 g/dL is ofen used for clinical stratifcation in HIV
infection [4].
Anaemia in HIV infection may result from direct efect
of the virus on the bone marrow through the expression
of proinfammatory cytokines that suppress erythropoiesis
[5]. A study in Malawi demonstrated a decreased number
of both CD34+ progenitor cells and primitive erythroid
progenitors in bone marrow of HIV-infected children [6]. A
report has demonstrated circulating autoantibodies against
endogenous erythropoietin in some HIV-infected patients
due to molecular mimicry between erythropoietin and the
HIV-1 p17 protein blunting the normal physiologic cytokine
response to anaemia [7]. Other causes of anaemia in HIV
infection include opportunistic infections, nutritional def-
ciencies from iron, folic acid, and vitamin B12, and toxicities
from medications such as antiretroviral therapy (ART) [4, 8].
Highly active antiretroviral therapy (HAART) regimen
(a combination of at least three drugs selected from the fol-
lowing main groups: nucleoside-analogue reverse transcrip-
tase inhibitors (NRTIs), nonnucleoside reverse transcriptase
inhibitors (NNRTIs), protease inhibitors (PIs), and entry
inhibitors) decreases viral replication, restores immunologic
function, and inhibits acceleration of HIV disease [9].
However, while some ART groups positively impart
FBC parameters, NRTIs, most especially zidovudine, the
frst drug approved for the treatment of HIV infection, has
Hindawi Publishing Corporation
Interdisciplinary Perspectives on Infectious Diseases
Volume 2016, Article ID 5210963, 5 pages
http://dx.doi.org/10.1155/2016/5210963