title: Circulating autoantibodies to erythropoietin are associated with human immunodeficiency virus type 1-related anemia.
abstract: In a cohort of 204 unselected consecutive human immunodeficiency virus type 1 (HIV-1)-infected patients, the association of circulating autoantibodies to endogenous erythropoietin (EPO) with HIV-1-related anemia was studied. Circulating autoantibodies to EPO were present in 48 (23.5%) of the 204 patients studied. Circulating autoantibodies were an independent predictor of anemia (odds ratio [OR]=5.0; 95% confidence interval [CI], 2.5-9.9), as strong as other known causes of anemia. The association of anti-EPO antibodies with anemia became stronger when the analysis was limited to the group of patients without any medical condition causing anemia (OR=10.4; 95% CI, 3.2-33.9). Moreover, the effect on hemoglobin levels remained significant even after adjusting for other anemia parameters. Anti-EPO autoantibodies were associated with higher EPO levels (r=.25, P=.012) and with a more prominent EPO response to anemia. Our findings suggest that autoimmunity, among other factors, may contribute to the pathogenesis of HIV-1-related anemia.
authors.affiliation: Department of Pathophysiology, Laikon General Hospital and School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. nsipsas@otenet.gr
authors.forename: N V
authors.initials: NV
authors.lastname: Sipsas
authors.forename: S I
authors.initials: SI
authors.lastname: Kokori
authors.forename: J P
authors.initials: JP
authors.lastname: Ioannidis
authors.forename: D
authors.initials: D
authors.lastname: Kyriaki
authors.forename: A G
authors.initials: AG
authors.lastname: Tzioufas
authors.forename: T
authors.initials: T
authors.lastname: Kordossis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000209:etiology*; D001323:Autoantibodies / Q000097:blood*; D015331:Cohort Studies; D004921:Erythropoietin / Q000032:analysis / Q000276:immunology*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology; D015497:HIV-1; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D001323:Autoantibodies; D006454:Hemoglobins; D004921:Erythropoietin