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Per Kallestrup

HIV and schistosomiasis in rural Zimbabwe: the association of Retinol-binding protein with disease progression, inflammation and mortality

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  • Sebastian Ranzi Kotzé, Denmark
  • Rutendo Zinyama-Gutsire, Zimbabwe
  • Per Kallestrup
  • Christine Stabell Benn, Denmark
  • Exnevia Gomo, Zimbabwe
  • Jan Gerstoft, Denmark
  • Govert van Dam, Netherlands
  • Ole Hartvig Mortensen, Afd. for Celle og Metabolismeforskning, Denmark
  • Henrik Ullum, Denmark
  • Christian Erikstrup

BACKGROUND: Vitamin A has widespread effects on immune function and is therefore interesting in HIV-infection. Retinol-binding protein (RBP or RBP4) is a negative acute-phase protein and a marker of vitamin A status. Our aim was to investigate the association of RBP with HIV progression, infection with schistosomiasis, inflammatory cytokines, and mortality.

METHODS: The study included 192 HIV-infected and 177 HIV-uninfected individuals from Mupfure in rural Zimbabwe. Of these, 208 were infected with Schistosoma haematobium, 27 with S. mansoni and 48 with both. Plasma RBP, HIV-RNA, CD4 cell count, haemoglobin, cytokines, clinical staging (CDC category), self-reported level of function (Karnoffsky Performance Score, KPS) and schistosomiasis status were assessed at baseline. Participants were followed for survival 3-4 years post-enrolment.

RESULTS: RBP levels were lower in HIV-infected individuals(p<0.0001). Among HIV-infected individuals, multivariable analysis showed RBP to be positively correlated with CD4 cell count(p=0.050), KPS(p=0.003), and haemoglobin(p<0.0001) and negatively correlated with HIV-RNA(p<0.0001), CDC category(p<0.0001), tumor necrosis factor-receptor II(p<0.0001) and interleukin(IL)-6(p=0.004), as well as with IL-8(p=0.005) and IL-10(p=0.003) for HIV-infected men. Furthermore, among HIV-infected individuals RBP correlated negatively with schistosomiasis(p=0.038) and intensity of infection: circulating anodic antigen(p=0.014), circulating cathodic antigen(p<0.0001) and faecal egg output(p=0.004).

CONCLUSIONS: In HIV-infected individuals, RBP was negatively associated with levels of inflammatory markers, markers of HIV progression, infection with schistosomiasis and markers of schistosomal intensity.

Original languageEnglish
JournalInternational Journal of Infectious Diseases
Pages (from-to)159-164
Number of pages6
Publication statusPublished - Apr 2015

    Research areas

  • retinol-binding protein, vitamin A, HIV, schistosomiasis, mortality, Africa

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