Effect of Sickle Cell Trait on the Treatment Response of Individuals Infected with Human Immune-Deficiency Virus (HIV)

Background: Sickle cell disease is of public health importance and comes with systemic organ complications that can cause long-term disabilities and early death.

Aim: This study was to determine the effect of co-existence between sickle cell gene (HbS) and HIV infection in a Lagos population.

Methods: The study was conducted at the anti-retroviral (ARV) outpatient clinic of the Nigerian Institute of Medical Research (NIMR), Yaba, Lagos. It is a cross-sectional cohort study of 292 adult HIV- positive patients who were enrolled for treatment and support in the centre between the year 2004-2015. A review of case notes and database was done to extract haematologic, immunologic, virologic and clinical information of the patients. The enrolled participants were invited for additional clinical and socio-demographic information using a structured questionnaire. Blood samples were collected and reanalysed to confirm the haemoglobin genotype. Data analysis was performed using SPSS software.

Results: Out of 292 recruited patients, 274 participants had complete data of which 74.1%, 22.9% and 2.9% were HbAA, HbAS and HbAC respectively. Sickle cell trait (SCT) was found in 25.9% of the participants and there was no record of sickle cell disease (SCD). HbAA participants were found to have a higher viral load (87.5%) at baseline (P < 0.001). For HbAA and SCT groups, treatment response over the years was similar with lower figures seen in SCT.

Conclusion: It was concluded that lower HIV viraemia in SCT might mean a delay in HIV-1 disease progression and subsequently better quality of life for such patients.