The relationship between asymptomatic human immunodeficiency virus infection and the prevalence and severity of anemia in pregnant Malawian women

The relationship between asymptomatic human immunodeficiency virus (HIV) in fection and blood hemoglobin (Hb) concentration was examined in anemic preg nant women from a population with high prevalence of both anemia (60%) and HIV seropositivity (30%). Sera from 155 pregnant women with Hb levels < 10. 5 g/dL were tested for HIV status, C-reactive protein (CRP), vitamin B-12, retinol, and folate levels. The observed prevalence of HIV seropositivity i n the group of women with anemia was 47.1% (95% confidence interval = -39.2 -55.0%). This is significantly higher than the HIV prevalence in the whole population (30.1%; P < 0.001). Median Hb values in HIV-seropositive and -se ronegative women with anemia were 8.40 g/dL and 8.95 g/dL, respectively. Se rum retinol, vitamin B-12, and folate levels were noe significantly differe nt in the HIV-seropositive and -seronegative groups. In women who were HIV- seropositive with normal levels of CRP, a median decrease in I-Ib of 0.4g/d L was observed. For those with serum CRP levels > 25 mg/l, the median decre ase in Hb was 0.7 g/dL. Results indicate that asymptomatic HIV infection is associated with increased prevalence and severity of anemia in pregnancy i n this population.