Authors : Zakaria EL KODMIRI; Abdelati Ouamani

Volume/Issue : Volume 9 - 2024, Issue 8 - August

Google Scholar : https://shorturl.at/kd0Uq

Scribd : https://shorturl.at/mUz5B

DOI : https://doi.org/10.38124/ijisrt/IJISRT24AUG813

Abstract : Human Immunodeficiency Virus (HIV) exerts profound effects on both the immune and hematological systems, leading to a range of complications that significantly influence patient outcomes and quality of life. This review examines the intricate interplay between HIV infection, immune system dysfunction, and hematological abnormalities. We detail the mechanisms underlying these complications, including the direct impact of HIV on CD4+ T lymphocytes, the persistent immune activation observed despite antiretroviral therapy (ART), and the diverse etiologies of HIV- associated anemia, thrombocytopenia, and leukopenia. Additionally, we address the clinical implications of these issues, emphasizing their role in disease progression and the current therapeutic approaches. This review highlights the imperative for continued research and the advancement of integrated care strategies to enhance long-term outcomes for individuals living with HIV.

Keywords : HIV; Immune Dysfunction; Hematological Abnormalities; CD4+ T Lymphocytes; Antiretroviral Therapy (ART); Chronic Immune Activation; Anemia; Thrombocytopenia; Leukopenia; Pathophysiology; Clinical Implications; Inflammation; Opportunistic Infections.

References :

1. UNAIDS. (2023). Global HIV & AIDS statistics — Fact sheet. UNAIDS. Retrieved from https://www.unaids.org/en/resources/fact-sheet
2. World Health Organization. (2023). HIV/AIDS. WHO. Retrieved from https://www.who.int/news-room/fact-sheets/detail/hiv-aids
3. Deeks, S. G., Overbaugh, J., Phillips, A., & Buchbinder, S. (2015). HIV infection. Nature Reviews Disease Primers, 1, 15035. https://doi.org/10.1038/nrdp.2015.35
4. Gupta, R. K., Abdul-Jawad, S., McCoy, L. E., Mok, H. P., Peppa, D., Salgado, M., ... & Olavarria, E. (2019). HIV-1 remission following CCR5Δ32/Δ32 haematopoietic stem-cell transplantation. Nature, 568(7751), 244-248. https://doi.org/10.1038/s41586-019-1027-4
5. Sundquist, W. I., & Kräusslich, H. G. (2012). HIV-1 assembly, budding, and maturation. Cold Spring Harbor Perspectives in Medicine, 2(7), a006924. https://doi.org/10.1101/cshperspect.a006924
6. Doitsh, G., Galloway, N. L., Geng, X., Yang, Z., Monroe, K. M., Zepeda, O., ... & Greene, W. C. (2014). Cell death by pyroptosis drives CD4 T-cell depletion in HIV-1 infection. Nature, 505(7484), 509-514. https://doi.org/10.1038/nature12940
7. Appay, V., & Sauce, D. (2008). Immune activation and inflammation in HIV-1 infection: causes and consequences. The Journal of Pathology: A Journal of the Pathological Society of Great Britain and Ireland, 214(2), 231-241. https://doi.org/10.1002/path.2276
8. Chun, T. W., Stuyver, L., Mizell, S. B., Ehler, L. A., Mican, J. A., Baseler, M., ... & Fauci, A. S. (1997). Presence of an inducible HIV-1 latent reservoir during highly active antiretroviral therapy. Proceedings of the National Academy of Sciences, 94(24), 13193-13197. https://doi.org/10.1073/pnas.94.24.13193
9. Brenchley, J. M., Price, D. A., Schacker, T. W., Asher, T. E., Silvestri, G., Rao, S., ... & Douek, D. C. (2006). Microbial translocation is a cause of systemic immune activation in chronic HIV infection. Nature Medicine, 12(12), 1365-1371. https://doi.org/10.1038/nm1511
10. Sandler, N. G., & Douek, D. C. (2012). Microbial translocation in HIV infection: causes, consequences and treatment opportunities. Nature Reviews Microbiology, 10(9), 655-666. https://doi.org/10.1038/nrmicro2848
11. McGary, C. S., Deleage, C., Harper, J., Micci, L., Ribeiro, S. P., Paganini, S., ... & Silvestri, G. (2017). CTLA-4+PD-1− memory CD4+ T cells critically contribute to viral persistence in antiretroviral therapy-suppressed, SIV-infected rhesus macaques. Immunity, 47(4), 776-788.e5. https://doi.org/10.1016/j.immuni.2017.09.018
12. Deeks, S. G. (2011). HIV infection, inflammation, immunosenescence, and aging. Annual Review of Medicine, 62, 141-155. https://doi.org/10.1146/annurev-med-042909-093756
13. Appay, V., & Rowland-Jones, S. L. (2002). Premature ageing of the immune system: the cause of AIDS? Trends in Immunology, 23(12), 580-585 https://doi.org/10.1016/S1471-4906(02)02338-4
14. Moir, S., Malaspina, A., & Fauci, A. S. (2011). Prospects for an HIV vaccine: leading B cells down the right path. Nature Structural & Molecular Biology, 18(2), 131-132. https://doi.org/10.1038/nsmb.2194
15. Moir, S., Malaspina, A., Ogwaro, K. M., Donoghue, E. T., Hallahan, C. W., Ehler, L. A., ... & Fauci, A. S. (2001). HIV-1 induces phenotypic and functional perturbations of B cells in chronically infected individuals. Proceedings of the National Academy of Sciences, 98(18), 10362-10367. https://doi.org/10.1073/pnas.181347898
16. Titanji, K., Chiodi, F., Bellocco, R., Schepis, D., Osorio, L., Vendrell, A., ... & Biberfeld, P. (2005). Primary HIV-1 infection sets the stage for important B lymphocyte dysfunctions. AIDS, 19(17), 1947-1955. https://doi.org/10.1097/01.aids.0000191231.54170.89
17. Plotkin, S. A. (2008). Vaccines: correlates of vaccine-induced immunity. Clinical Infectious Diseases, 47(3), 401-409. https://doi.org/10.1086/589862
18. Alter, G., & Altfeld, M. (2011). NK cells in HIV-1 infection: evidence for their role in the control of HIV-1 infection. Journal of Internal Medicine, 269(1), 29-42. https://doi.org/10.1111/j.1365-2796.2008.02045.x
19. Wallet, M. A., Rodriguez, C. A., Yin, L., Saporta, S., Chinratanapisit, S., Hou, W., ... & Chang, L. J. (2010). Microbial translocation induces persistent macrophage activation unrelated to HIV-1 levels or T-cell activation following therapy. AIDS, 24(9), 1281-1290. https://doi.org/10.1097/QAD.0b013e328339e228
20. Ellis, R. J., Caligiuri, M., & McCune, J. M. (2007). Immunopathogenesis of HIV infection. Immunological Reviews, 218(1), 29-44. https://doi.org/10.1146/annurev.micro.50.1.825
21. Belperio, P. S., & Rhew, D. C. (2004). Prevalence and outcomes of anemia in individuals with human immunodeficiency virus: a systematic review of the literature. The American Journal of Medicine, 116(Suppl 7A), 27S-43S. https://doi.org/10.1016/j.amjmed.2003.12.010
22. Weiss, G., & Goodnough, L. T. (2005). Anemia of chronic disease. New England Journal of Medicine, 352(10), 1011-1023. https://doi.org/10.1056/NEJMra041809
23. Sullivan, P. S., Hanson, D. L., Chu, S. Y., Jones, J. L., & Ward, J. W. (1998). Epidemiology of anemia in human immunodeficiency virus (HIV)-infected persons: results from the multistate adult and adolescent spectrum of HIV disease surveillance project. Blood, 91(1), 301-308. https://doi.org/10.1182/blood.V91.1.301
24. Semba, R. D., Shah, N., Klein, R. S., Mayer, K. H., Schuman, P., Vlahov, D., & Womens Interagency HIV Study. (2002). Prevalence and cumulative incidence of and risk factors for anemia in a multicenter cohort study of HIV-infected and uninfected women. Clinical Infectious Diseases, 34(2), 260-266. https://doi.org/10.1086/338151
25. Awamura T, Nakasone ES, Gangcuangco LM, Subia NT, Bali A-J, Chow DC, et al. Title of the article. Journal Name. 2023 Nov; 13(11): 1608. https://doi.org/10.3390/biom13111608.
26. Talargia F, Getacher L. Thrombocytopenia and associated factors among HIV-infected patients in pre- and post-anti-retroviral therapy, North East Ethiopia. Journal of Blood Medicine. 2021; 12: 741-748. https://doi.org/10.2147/JBM.S323086
27. Phillips AN, Lazzarin A, Gonzales-Lahoz J, Lundgren JD, Johnson AM; The AIDS in Europe Study Group. Factors associated with the CD4+ lymphocyte count at diagnosis of acquired immunodeficiency syndrome. J Clin Epidemiol. 1996 Nov;49(11):1253-1258. DOI: https://doi.org/10.1016/S0895-4356(96)00216-8.
28. Redig, A. J., & Berliner, N. (2013). Pathogenesis and clinical implications of HIV-related anemia in 2013. Hematology/Oncology Clinics, 27(2), 337-352. https://doi.org/10.1182/asheducation-2013.1.377
29. Tilahun M, Gedefie A, Ebrahim E, Seid A, Ali A, Shibabaw A, Belete MA, Fiseha M, Tesfaye M, Ebrahim H, Abera A. Immuno-haematological abnormalities of HIV-infected patients before and after initiation of highly active antiretroviral therapy in the antiretroviral therapy clinics of six health facilities at Dessie Town, Northeast Ethiopia. J Blood Med. 2022;13:243-253. DOI: https://doi.org/10.2147/JBM.S364700.
30. Mocroft, A., Lifson, A. R., Touloumi, G., Baxter, J., Clumeck, N., D'Arminio Monforte, A., ... & Ledergerber, B. (1999). Haemoglobin and anaemia in the SMART study: associations with clinical and laboratory parameters. Antiviral Therapy, 14(8), 1097-1104. https://doi.org/10.3851/IMP1746