Article
The association of infection and clinical severity in sickle cell anaemia patients.
Registration in:
MOURA NETO, J. P. et al. The association of infection and clinical severity in sickle cell anaemia patients.Transactions of the Royal Society of Tropical Medicine and Hygiene, v. 105, n. 3, p. 121-126, 2011.
1878-3503
10.1016/j.trstmh.2010.11.007
Author
Moura Neto, José Pereira de
Lyra, Isa Menezes
Reis, Mitermayer Galvão dos
Gonçalves, Marilda de Souza
Abstract
Sickle cell anaemia (SCA) patients have a high risk of infection. We retrospectively investigated
the prevalence of infection among SCA patients from Bahia, Brazil. A total of 1415
SCA patients were studied between 1995 and 2009: 190 (13.4%) had hepatitis C virus (HCV),
67 (4.7%) had human T-lymphotropic virus type I (HTLV-I), 44 (3.1%) had hepatitis B virus
(HBV), 40 (2.8%) had Chagas’ disease, 11 (0.8%) had human immunodeficiency virus (HIV),
and 5 (0.4%) had syphilis. Patients with HCV infection had a higher risk of hospitalisation
(OR = 1.52, 95% Cl: 1.07-2.17, P = 0.020), bone disorders (OR = 1.94, 95% Cl: 1.15-3.27,
P = 0.011), stroke (OR = 2.17, 95% Cl: 1.12–4.14, P = 0.017), painful crisis (OR = 1.61, 95% Cl:
1.17-2.22, P = 0.004) and leg ulcers (OR = 1.61, 95% Cl: 1.04-3.03, P = 0.031). Patients with
HBV infection had a higher risk for bone disorders (OR = 4.90, 95% Cl: 2.08-11.54, P < .010),
stroke (OR = 3.01, 95% Cl: 1.29-6.04, P = 0.007), painful crisis (OR = 3.51, 95% Cl: 1.62-7.63,
P < 0.001), acute chest syndrome (ACS) (OR = 2.66, 95% Cl: 1.34-5.28, P = 0.004), leg ulcers
(OR = 6.60, 95% Cl: 3.37-12.91, P < .001) and vaso-occlusive crisis (OR = 6.34, 95% Cl: 1.96-
20.66, P < 0.001). Patients with HTLV-I infection had a high risk for bone disorders (OR = 2.94,
95% Cl: 1.28-6.74, P = 0.011), respiratory failure (OR = 2.66, 95% Cl: 1.26-5.51, P = 0.012), leg
ulcers (OR = 3.27, 95% Cl: 1.69-6.11, P < .001), painful crisis (OR = 1.82, 95% Cl: 1.07-3.13,
P = 0.025) and ACS (OR = 1.85, 95% Cl: 1.10-3.41, P < .047). SCA patients with HCV infection
had increased triglycerides and low-density lipoprotein cholesterol (P = 0.036; P = 0.027),
iron serum (P = 0.016) and ferritin (P = 0.007). These results reveal important roles for these
infections in SCA patients’ clinical outcomes, and studies are warranted to determine the
mechanisms utilised by these agents and their involvement in disease severity.
Subjects
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