Objective Some studies suggest that HIV infection progresses slowly in patients with sickle cell disease (SCD). The authors aimed to determine the relationships between SCD and HIV infection.
Methods National Hospital Discharge Survey data from adult African–Americans in the period of 1997–2009 were analysed. The comorbidities of SCD with HIV infections in hospital discharges were analysed. Multiple logistic regression was used to test the association between SCD and HIV. For comparative purposes, the relationships of SCD with hepatitis B virus (HBV) and hepatitis C virus (HCV) were also assessed.
Results 423 431 records were divided into two time periods 1997–2003 (53% of records) and 2004–2009 (47% of records). The frequency of HIV diagnosis was lower in patients with SCD (1.5% vs 3.3% in patients without SCD). In logistic regression, SCD diagnosis was associated with an OR of 0.24 (95% CI 0.18 to 0.32) for HIV diagnosis in the first period and with an OR of 0.31 (95% CI 0.22 to 0.42) in the second period. In contrast, SCD was associated with higher risk of HCV (OR=2.01, 95% CI 1.56 to 2.59 in the first period and OR=2.12, 95% CI 1.71 to 2.63 in the second period). SCD was also associated with a higher risk of HBV (OR=1.15, 95% CI 0.72 to 1.83 in the first period and OR=1.82, 95% CI 1.24 to 2.68 in the second period).
Conclusions The lower risk of HIV comorbidity, but not HCV and HBV, with SCD is consistent with the possibility that SCD has a unique effect in altering the risk of HIV infection or progression. Investigation of how the haemolytic and immunological changes of SCD influence HIV might lead to new therapeutic or preventive approaches.
- Hepatitis B
- hepatitis C
- National Hospital Discharge Survey
- sickle cell disease
- epidemiology (clinical)
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Funding This study was supported by Howard University Research Scientist Award (UH1 HL03679), Pulmonary Hypertension and Hypoxic Response grant (R01 HL079912), walk-PHaSST (treatment of Pulmonary Hypertension and Sickle cell disease with Sildenafil Therapy) Study (HHSN268200617182C) and Research Centers in Minority Institutions (RCMI) grant (RCMI-NIH 2G12RR003048) from the Division of Research Infrastructure, National Center for Research Resources, NIH, NIH SCORE Grant (SC1GM082325) and NHLBI Research Center at Howard University grant (1P30HL107253).
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.