G.R. KHASANOVA^1,2, O.I. BIKKININA², V.A. ANOKHIN¹

Kazan State Medical University, 49 Butlerov St., Kazan, Russian Federation, 420012

Republican Center for the Prevention and Control of AIDS and infectious diseases of the Ministry of Health of the Republic of Tatarstan, 2a Vishnevskiy St., Kazan, Russian Federation, 420097

Khasanova G.R. — Cand. Med. Sc., Acting Head. of the Department of Epidemiology, Infectious Disease Physician, tel. (843) 267-80-06, e-mail: [email protected]^1,2

Bikkinina O.I. — Cand. Med. Sc., Infectious Disease Physician, tel. (843) 238-17-43, e-mail: [email protected]²

Anokhin V.A. — D. Med. Sc., Professor, Head of the Department of Children Infectious Diseases, tel. (843) 267-81-00, e-mail: [email protected]¹

The purpose of the research was to study the link between anemia of a chronic disease and microbial translocation in patients with HIV-infection. There were surveyed 63 patients with asiderotic anemia. Were determined endotoxin levels in serum, sCD14, anti-RE-glycolipid Salmonella minnesota and E. coli lipopolysaccharide O14. SCD14 and endotoxin levels in patients with anemia of chronic disease were significantly higher than those of the group with iron deficiency anemia, which can be regarded as a higher level of microbial translocation in the first group of patients. There was also found an inverse correlation with the level of hemoglobin concentration sCD14: r =-0,7; p=0,002. In the dynamics there were examined 16 patients with anemia of chronic disease after 4 weeks of therapy aimed at correction of hyperendotoxinemia and including probiotic, enterosorbent, diuretic and choleretic drugs. Treatment of patients showed improvement.In patients who did not receive antiretroviral therapy, there was a statistically significant decrease in the levels of endotoxin and IL-1β, and increase in hemoglobin. Thus, the development of anemia of chronic disease in HIV infection is partially explained by the phenomenon of microbial translocation.

Key words: HIV-infection, anemia, microbial translocation, endotoxin.

 

 

REFERENCES

1. Levine A.M., Berehane K., Karim R. et al. Impact of highly active antiretroviral therapy on anemia and relationship between anemia and survival in a large cohort of HIV-infected women: Women’s interagency HIV Study. J. Acquir. Immune Defic. Syndr., 2004, vol. 37 (2), pp. 1245-1252.

2. Semba R.D., Martin B.K., Kempen J.H. et al. Ocular Complications of AIDS Research Group. The impact of anemia on energy and physical functioning in individuals with AIDS. Arch. Intern. Med., 2005, vol. 165, no. 19, pp. 2229-2236.

3. Cavaillon J.M., Adrie C., Fitting C., Adib M. Conquy Endotoxin tolerance: is there a clinical relevance? J Endotoxin Res., 2003, vol. 9, pp. 101-107.

4. Brenchley J.M., Price D.A., Schacker T.W. et al. Microbial translocation is a cause of systemic immune activation in chronic HIV. Nat Med., 2006, vol. 12, pp. 1365-1371.

5. Enukidze G.G., Anikhovskaja I.A., Marachev A.A., Yakovlev M.Yu. Antiendotoksinovoje napravlenije v lechenii khronicheskogo vospalenija i zhenskogo besplodija [Antiendotoxic direction in treatment of chronic inflammation and female infertility]. Мoscow: Novii lechebno-diagnosticheskie tekhnologii [New diagnostic and treatment technologies], 2007. 80 p.

6. Vyshegurov Ya.Kh., Zakirova D.Z., Rascheskov A.Yu., Yakovlev M.Yu. Kishechnyy endotoksin kak obligatnyy faktor patogeneza endogennykh iridotsiklitov i endoftalmitov neyasnoy etiologii. [Intestinal endotoxin as obligate factor of pathogenesis of endogenic iridocyclitis and endophtalmitis of unknown origin]. Мoscow: Novii lechebno-diagnosticheskie tekhnologii [New diagnostic and treatment technologies], 2006. 133 p.

7. Sullivan P.S. Impact on hemoglobin of starting combination antiretroviral therapy with or without zidovudine in anemic HIV-infected patients. J Acquir Immune Defic Syndr., 2008, vol. 48, pp. 163-168.

8. Khasanova G.R., Stepanova E.Ju., Mustafin I.G. Erythropoietin and anemia of chronic disease in patients with HIV-infection. Prakticheskaja meditsina, 2014, no 1, pp. 129-133 (in Russ.).