Circulating antibodies to endogenous erythropoietin and risk for HIV-1-related anemia.
OBJECTIVE
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+/-31.7 IU/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.
Tsiakalos
Aristotelis
A
Department of Pathophysiology, National and Kapodistrian University of Athens, Greece. atsiakalos@gmail.com
Kordossis
Theodore
T
Ziakas
Panayiotis D
PD
Kontos
Athanasios N
AN
Kyriaki
Despina
D
Sipsas
Nikolaos V
NV
D000328:Adult; D000740:Anemia / Q000175:diagnosis* / Q000209:etiology*; D001323:Autoantibodies / Q000097:blood*; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay; D004921:Erythropoietin / Q000276:immunology*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis
D001323:Autoantibodies; D004921:Erythropoietin