Original Communication
European Journal of Clinical Nutrition (2005) 59, 526–532. doi:10.1038/sj.ejcn.1602116 Published online 2 March 2005 doi:1602116A/sj.bjp.0704832
Low plasma selenium concentrations, high plasma human immunodeficiency virus load and high interleukin-6 concentrations are risk factors associated with anemia in adults presenting with pulmonary tuberculosis in Zomba district, Malawi
Guarantors: M van Lettow, RD Semba.
Contributors: MvL has been in charge of the collection and analysis of data and writing of the manuscript. Provision of significant advice and consultation was given by CEW, JWMvdM, FTW and RDS.
M van Lettow1, C E West2, J W M van der Meer3, F T Wieringa3 and R D Semba1
- 1Johns Hopkins University School of Medicine, Baltimore, USA
- 2Wageningen Agricultural University, Division of Human Nutrition and Epidemiology, The Netherlands
- 3Radboud University Nijmegen Medical Centre, The Netherlands
Correspondence: M van Lettow, 550 North Broadway, Suite 700, Baltimore, MD 21205, USA. E-mail: mvlettow@imailbox.com
Received 21 September 2004; Revised 22 November 2004; Accepted 10 December 2004; Published online 2 March 2005.
Abstract
Background:
Although anemia is common among adults with pulmonary tuberculosis and human immunodeficiency virus (HIV) infection in sub-Saharan Africa, the factors contributing to its pathogenesis have not been well characterized.
Objective:
To characterize the antioxidant micronutrient status, interleukin-6 (IL-6) concentrations, and HIV load in relationship with anemia in adults with pulmonary tuberculosis.
Setting:
Zomba district, Malawi.
Methods:
Erythropoietin, IL-6, plasma HIV load, and markers of micronutrient status (hemoglobin (Hb), plasma concentrations of retinol, 
-tocopherol, carotenoids, ferritin, zinc, and selenium) were measured in 500 adults who presented with pulmonary tuberculosis in Zomba Central Hospital, Malawi.
Results:
Among 370 HIV-positive and 130 HIV-negative adults, the prevalence of anemia was 88 and 77%, respectively (P=0.002), and moderate to severe anemia (Hb<80 g/l) occurred in 30 and 15%, respectively (P=0.001). Geometric mean IL-6 concentration was 21.1 pg/ml, with no difference between HIV-positive and -negative adults. The erythropoietin response to anemia was not different between adults with elevated IL-6 and those with lower IL-6 concentrations. In a multivariate logistic regression model, HIV load, and lower plasma selenium concentrations were associated with moderate to severe anemia. In a final multivariate linear regression model, IL-6, plasma HIV load, and plasma selenium concentrations were associated with Hb concentrations.
Conclusion:
This study suggests that low selenium concentrations, high HIV load, and high IL-6 concentrations are associated with anemia in adults with pulmonary tuberculosis in sub-Saharan Africa.
Keywords:
anemia, erythropoietin, selenium, tuberculosis, HIV
MORE ARTICLES LIKE THIS
These links to content published by NPG are automatically generated
NEWS AND VIEWS
Prostate cancer Neither vitamin E nor selenium prevent prostate cancer
Nature Reviews Urology News and Views (01 Apr 2009)
