Investigating Reticulocyte Count, Serum Ferritin, and Transferrin in HIV Infected Patients in Owerri, Nigeria

Abstract

Human immunodeficiency virus (HIV) infection remains a major global health challenge, and hematological abnormalities especially anemia are among its most common complications. Anemia in HIV infected individuals has been associated with disease progression, decreased quality of life, and increased mortality. Iron metabolism disturbances and impaired erythropoiesis are frequently implicated, yet data from many African settings remain sparse. This study evaluated reticulocyte count, serum ferritin, and transferrin levels in HIV infected adults attending Imo Specialist Hospital, Owerri, Nigeria, compared with age and sex matched HIV negative controls. In a comparative cross-sectional design, 30 HIV-positive adults and 30 controls were recruited. Reticulocyte counts were determined by standard microscopy after new methylene blue staining; serum ferritin and transferrin were measured using immunoassays. HIV-infected patients exhibited significantly lower mean reticulocyte counts (0.22)% compared to controls (0.850%,(p < 0.0001) and transferrin levels (164.50 ± 84.04) mg/dL compared to controls (284.77 ± 89.01) mg/dL, (p < 0.0001), and markedly higher serum ferritin (432.70 ± 240.07) ng/mL compared to controls (65.67 ± 49.60) ng/mL, (p < 0.0001) compared to the control group. There were no significant differences by sex or across age strata. Correlation analysis did not reveal significant associations between reticulocyte count and either ferritin or transferrin, suggesting that anemia in this context may be multifactorial and not solely due to iron deficiency. The findings support the concept of anemia of chronic disease (ACD) in HIV infection and underscore the need for comprehensive iron status assessment in HIV care.