title: Plasma folate studies in HIV-positive patients at the Lagos university teaching hospital, Nigeria.
abstract: BACKGROUND
  In various studies globally, the prevalence of anemia in persons with HIV infection range from 10 to 20% at initial presentation, and anemia is diagnosed in 70 to 80% of these patients over the course of HIV disease. The etiology of anemia in this group of patients has not been fully established, thus a need to evaluate the role of plasma folate as a possible etiological factor.
  
  
  OBJECTIVE
  This study was set to determine plasma folate levels in newly diagnosed, treatment naïve, HIV-positive patients, and relate this to other hematological changes.
  
  
  METHODS
  A total of 200 participants were recruited for this study, of which 100 were HIV positive, treatment naive patients who were recruited at the point of registration and 100 were HIV-negative subjects (controls). 5 ml of venous blood was collected and plasma extracted for folic acid estimation by HPLC. A full blood count, CD4 and Viral load were estimated.
  
  
  RESULTS
  Mean ages for control and study group were 38 ± 2.3 and 32 ± 1.7 years, respectively. Mean plasma folate concentration among the study group (5.04 μg/l) was significantly lower than that for the control group (15.89 μg/l; P = 0.0002). Prevalence of anemia among the study group was 72% (144 of 200), with a mean hemoglobin (Hb) concentration of 9.5 g/dl compared with mean Hb of 13.0 g/dl among the control group (P = 0.002). Plasma folate correlated positively with CD4 cell count (r = 0.304, P<0.05) and inversely with the viral load (r = -0.566; P<0.05).
  
  
  CONCLUSIONS
  Plasma folate level is a predictor of anemia in early HIV infections.
authors.affiliation: Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos, Surulere, Lagos, Nigeria.
authors.forename: Akanmu
authors.initials: A
authors.lastname: Alani
authors.forename: Osunkalu
authors.initials: O
authors.lastname: Vincent
authors.forename: Adediran
authors.initials: A
authors.lastname: Adewumi
authors.forename: Adeyemo
authors.initials: A
authors.lastname: Titilope
authors.forename: Ernest
authors.initials: E
authors.lastname: Onogu
authors.forename: Akinde
authors.initials: A
authors.lastname: Ralph
authors.forename: Coker
authors.initials: C
authors.lastname: Hab