Viral Load Dynamics in Sickle Cell Patients Living with HIV: A Narrative Review


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Article type :

Review article

Author :

Emmanuel Ifeanyi Obeagu,Olga Georgievna Goryacheva

Volume :

12

Issue :

1

Abstract :

The coexistence of Sickle Cell Disease (SCD) and Human Immunodeficiency Virus (HIV) infection presents a unique and complex clinical challenge due to the intricate interplay between chronic hemolytic anemia, immune dysregulation, and viral replication. SCD is characterized by chronic inflammation, functional asplenia, and frequent blood transfusions, all of which contribute to an altered immune environment that may influence HIV viral load dynamics. Conversely, HIV-induced immunosuppression can exacerbate SCD complications, increasing susceptibility to infections and organ damage. Understanding how these two conditions interact is essential for optimizing viral suppression and managing hematological complications in co-infected individuals. Antiretroviral therapy (ART) remains the cornerstone of HIV management, but its effectiveness in SCD patients can be compromised by factors such as chronic inflammation, drug toxicity, and transfusion-related complications. Certain ART regimens, especially those with hematologic side effects, may worsen anemia and bone marrow suppression in SCD patients, complicating adherence and viral load control. Additionally, blood transfusions, a common intervention in SCD, can trigger immune activation and iron overload, potentially affecting ART pharmacokinetics and viral replication. These challenges necessitate personalized treatment strategies that balance effective HIV suppression with the management of SCD-related complications.

Keyword :

Viral Load, Sickle Cell Disease, HIV, Antiretroviral Therapy, Immune Response