%0 Journal Article
%T A Comparison of Hemoglobin Levels in Untreated and Treated Groups of HIV Patients on ART Including Zidovudine
%A Jitendra Singh Nigam
%A Jyotsna Naresh Bharti
%A Dinker Kumar
%A Ankit Sharma
%J Pathology Research International
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/828214
%X Objective. To assess the level of haemoglobin A2 in HIV patients on antiretroviral therapy (ART) including zidovudine with untreated HIV patients. Material and Methods. The study was a case control study. A total of 185 patients were included in the study; the case group included 125 HIV patients who were on antiretroviral therapy (ART) including zidovudine and 60 were in the control group who were not receiving ART. The high-performance liquid chromatography (HPLC) was done and hemoglobin A2 level was observed; value more than 3.5% was considered significant. The Hb A2 percentages of HIV patients were compared with those of control using an unpaired t-test. Results. The mean of Hb A2 in case group was 3.462% (SD 0.675) and in control group it was 2.815% (SD0.246). The higher Hb A2 value was seen in significant number of treated patients than control group ( ). Conclusion. The clinicians, pathologists, haematologists, and genetic counsellors should be aware of effects of nutritional anaemia and ART on Hb A2 to reduce the chances of misdiagnosis of ¦Â-thalassaemia especially in developing countries and for centres for antenatal screening. 1. Introduction Cooley and Lee were the first to describe the diminished rate of synthesis of one or more globin chains or its part, which consequently results in reduced rate of synthesis of the haemoglobin. Whipple and Bradford in 1936 gave the term ¡°Thalassaemia¡± [1]. -thalassaemia is commonly seen in Mediterranean region, Indian subcontinent, Southeast Asia, and African ancestry [1]. For -thalassaemia, screening of populations was done either by measuring the haemoglobin A2 percentage or by red cell indices in patients with MCV or MCH below a certain cut-off point [1]. The haemoglobin A2 is 4%-5% in most cases of heterozygous or severe thalassaemia and 3.6¨C4.2% in heterozygous mild thalassaemia [1]. The raised Hb A2 values are seen in unstable haemoglobins, hyperthyroidism, and megaloblastic anaemia, and human-immunodeficiency-virus- (HIV-) infected patients on antiretroviral therapy, while hypochromic microcytic red cell picture is seen only in heterozygous -thalassaemia [2]. History, clinical details, and coexisting condition help to rule out the causes of increase in Hb A2, which can avoid unnecessary investigation and reduce the financial burden of institutional setting in developing countries. Awareness of the fact that there are increases in Hb A2 due to antiretroviral drugs among clinicians and pathologists should be must. Spiga et al. reported that zidovudine inhibits -globin gene expression in human
%U http://www.hindawi.com/journals/pri/2013/828214/