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Journal : Journal of Global Pharma Technology

Inverse Correlation between Combination of Antiretroviral Therapy with the level of Serum Interleukin-6, Ferritin, and Hepcidin in HIV Patients with Anemia Chronic Disease I Ketut Agus Somia; Ketut Tuti Parwati Merati; I Made Bakta; Ida Bagus Putra Manuaba; Wayan Putu Sutirta Yasa; I Dewa Made Sukrama; Ketut Suryana; Rudi Wisaksana
Journal of Global Pharma Technology .
Publisher : Journal of Global Pharma Technology

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Abstract

Background: The purpose of this study was to determine whether the cARV therapy correlates with the serum level of IL-6, ferritin, and hepcidin in HIV infected patients with ACD.Methods: A cross-sectional study conducted in HIV patients with ACD, aged 15-65 years with exclusion criteria such as chronic renal disease, chronic liver disease, treated for anemia in the last 3 months, taking iron supplements in the last 3 months, history of blood transfusion in the last 1 year, suffering from acute infection, tuberculosis infection, malignancy, hepatitis C virus infection, acute hypersensitivity reaction and pregnancy. Blood specimen examined by high sensitivity human IL-6 In vitro ELISA, DRG Hepcidin- 25 ELISA, serum ferritin by agglutination method and CD4 cell count by flow cytometry. Results: A total of 86 HIV patients with ACD consist of 42 subjects with experienced cARV and 44 subjects with naive cARV. There are several differences between cARV naïve and experienced cARV including: Hb (g/dl) [ 10.8 ( 9.88 – 11.75) Vs. 11.60 (11.00 – 12.34) p: 0.058 ], serum iron (mg/dl) [ 50.00 (31 – 66.8) Vs. 71.40 (56.00 – 108.00) p: 0.121 ), serum ferritin (ug/dl) [ 630 ( 194 – 1101) Vs. 195.40 (128.25 – 589.47) p: 0.008 ], IL-6 (pg/mL) [7.20 (3.88 – 10.76) Vs. 4.03 (1.69 – 8.49) p: 0.009), serum hepcidin (ng/mL) [45.54 (16.74 – 95.31) Vs. 23.35 (6.58 – 49.99) p: 0.007] , CD4 cell count (cell/uL) [31.5 (14.25 – 90.75) Vs. 307 (168.5 – 458.75) p : < 0.001)] There is a significant inverse correlation between the cARV therapy with level of serum IL-6 ( r: - 0. 285, p: 0.008), ferritin (r: - 0.321, p: 0.007) and hepcidin (r: - 0.293, p: 0.006). While there was a significant positive correlation between the cARV therapy with CD4 cell count (r: 0.676, p: 0.001). There was no correlation between the cARV therapy with serum iron levels ( r: 0.176, p: 0.121).Conclusion: There is an inverse correlation between the cARV therapy with serum level of IL-6, ferritin, and hepcidin in HIV patients with ACD.  Keywords: cARV, ACD, IL-6, Ferritin, Hepcidin.
Reticulocyte Hemoglobin Equivalent (RET-HE) As A Predictor and Early Marker for Oral Iron Response in Iron Deficiency Anemia Patients Ketut Suega; I Made Bakta
Journal of Global Pharma Technology Volume 10 Issue 06: (2018) June 2018
Publisher : Journal of Global Pharma Technology

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Abstract

This study was aimed to determine whether Ret-He has a role for early detection and as a predictor factor for treatment response in iron deficiency anemia patient after oral iron therapy in 4 weeks. Iron deficiency anemia (IDA) patient were diagnosed based on hypochromic microcytic anemia with ferritin level < 20 ng/ml. All patients were taking oral iron pill for 4 weeks. Hemoglobin serum, absolute reticulocyte count (ARC), Ret-He, MCV, MCH, MCHC, and hematocrit were measured. Responders are defined as patients who reach total changes of their hemoglobin level > 2 g/dl in 4 weeks. Data analysis was done by SPSS. There were 26 IDA patients consisted of 15 (57.7%) female and 11 (42.3%) male patients with mean of age was 47.31. Before treatment, level of Ret-He, absolute reticulocyte count, HB, HCT and MCV were 18.16 pg (SD 4.43), 0.67 (SD 3.02), 7.94 g/dl (0.74), 26.5 % (SD 2.48), 64.9 fl (SD 0.51) respectively. There was 18 (69.2%) patient considered as responders and 8 (30.8%) patients considered as non-responders. The evaluation showed all markers were increased except for absolute reticulocyte level. On adjusted multiple logistic regression, the only variable that found statistically significant was Ret-He at week 1 with p= 0.031; 95% CI 0.349-0.950. It is suggested that reticulocyte hemoglobin equivalent (Ret-He) proved to be an early and sensitive predictor for oral iron therapy response in patients with iron deficiency anemia. Keywords: Ret-He, Treatment response, Iron deficiency anemia.
Co-Authors - Murtiananingsih, - - Saimi, - A. A. Mas-Putrawati AAG Sudewa D. Adi Purwa Hita, I Putu Gede Alma Lystia Savitri Mahayasa Ambrosius Purba Anisa Hanum Anwar Santosa Ariati, N.N. Arundina Sanyoto Astawa N. M., Astawa N. Astawa P., Astawa Brad Otto Budha K. Claire Ryan Daniel Womsiwor Dewa Nyoman Wirawan Dewa Nyoman Wirawan, Dewa Nyoman Dharmayuda, Tjokorda Gede Dhiancinantyan Windydaca Brata Putri Djoko Roeshadi Duarsa, Dyah Paramita Dwidjayanti, Ni Kadek Candra Dyah Kanya Wati Dyah Pradnya P.D., Dyah Pradnya Dyah Pradnya Paramitha Duarsa Dyah Pradnya Paramitha Duarsa, Dyah Pradnya Paramitha Dyah Pradnyaparamita D, Dyah Pradnyaparamita Ekaputra Ekaputra, Ekaputra Gusti Putu Surya H. S. Habiba Muhiddin, H. S. Habiba Hari Bagianto I Dewa Made Sukrama I Dewa Nyoman Wirawan I Dewa Putu Sutjana I Ketut Agus Somia I Ketut Suastika I Ketut Suyasa I Made Ady Wirawan I Made Damriyasa I Made Duwi Sumohadi I Made Jawi I Made Jawi I Made Sudarmaja I Made Susila Utama I N Agus Bagiada I NYOMAN ADI SURATMA I Nyoman Arhya I Nyoman Budi Hartawan I Nyoman Mangku Karmaya I NYOMAN MANTIK ASTAWA I Nyoman Sutarsa I Putu Budi Wibawa I Putu Gede Adiatmika I Putu Suiraoka I Putu Wantera I Wayan Losen Adnyan I Wayan Losen Adnyana I Wayan Putu Sutirta Yasa I Wayan Suranadi I Wayan Wita Ida Bagus Gede Suparyatha Ida Bagus Komang Ardana Ida Bagus Putra Manuaba Ida Bagus Subanada IN Agus Bagiada IN Bagiada INT Suryadhi INT Suryadhi J. A. Pangkahila Karjono M, Karjono Ketut Siki Kawiyana Ketut Suata Ketut Suega Ketut Suega Ketut Suryana Ketut Tuti Parwati Merati Kusuma, Anak Agung Ngurah Jaya Lesmana, Cokorda Agung Bagus Jaya Levi Anatolia Losen Adnyan Ludirdja, Evan Pratama LUH MERTASARI . Luh Seri Ani Made Jawi Made Krisna Adi Jaya Made Wiryana Manuaba, I.B.P Mirandinha Fortuna Sarmento Madeira, Angie N Adiputra N. Adiputra N. K. Niti Susila, N. K. Ni Made Andrinia Ratih Sri Indarswari Ni Nyoman Yunita Kusuma Bakta Ni Putu Aryati Suryaningsih Nita Fitria P. Astawa Purnamawati, Susy R. A.T. Kuswardhani Rena, Ni Made Renny A Rena, Ni Made Renny Anggreni Renny A Rena Rudi Wisaksana Santosa, I Gusti Ngurah Putra Eka Satoto D., Satoto Sawitri, Anak Agung Sagung Shannon Turnbul Sri Maliawan Sumohadi, I Made Duwi Suryadi N. T., Suryadi N. Sutajaya, I.M. Sutema, Ida Ayu Manik Partha Tirtayasa, K. Tjok Darmayuda Tjok Gde Darmayuda Tjokorda Gde Agung Senapathi Tjokorda Gde Bagus Mahadewa Tjokorda Gde Dharmayuda Tjokorda Gde Dharmayuda Tuti Parwati Merati W. A., W. Winarto, Daniel Wiryana M., Wiryana Wulansari Manuaba, Ida Ayu Ratih Xavier Leverve Yenny Kandarini