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Elite Journal of Scientific Research and Review. Volume 2 issue 1(2024), Pp. 24-36
https://epjournals.com/journals/EJSRR
Citation: Obeagu EI, Obeagu, GU. The Crucial Role of Erythropoietin in Managing Anemia in
HIV: A Review. Elite Journal of Scientific Research and Review, 2024; 2(1): 24-36
1
The Crucial Role of Erythropoietin in Managing Anemia in HIV: A Review
*Emmanuel Ifeanyi Obeagu1 and Getrude Uzoma Obeagu2
1Department of Medical Laboratory Science, Kampala International University, Uganda.
2School of Nursing Science, Kampala International University, Uganda.
*Corresponding authour: Emmanuel Ifeanyi Obeagu, Department of Medical Laboratory Science,
Kampala International University, Uganda, emmanuelobeagu@yahoo.com, ORCID: 0000-0002-
4538-0161
Abstract
Anemia is a pervasive complication in individuals living with HIV/AIDS, significantly
diminishing their well-being and overall health. This comprehensive review explores the intricate
relationship between anemia and HIV, emphasizing the pivotal role of erythropoietin (EPO) in
managing this hematologic challenge. Chronic inflammation, opportunistic infections, and adverse
effects of antiretroviral therapy contribute to the multifactorial nature of anemia in HIV. EPO, a
key regulator of erythropoiesis, emerges as a promising therapeutic avenue. This review delves
into the mechanisms underpinning anemia in HIV, elucidates the physiological regulation of EPO,
and investigates the impact of HIV on endogenous EPO production. A critical analysis of clinical
studies assessing exogenous EPO supplementation provides insights into optimal dosages,
treatment duration, and potential challenges. Recognizing iron deficiency as a common
contributor, the review explores strategies to address it concurrently with EPO supplementation.
Future directions and challenges in erythropoietin therapy for HIV-associated anemia are
discussed, underscoring the need for ongoing research to refine treatment approaches and improve
patient outcomes. In conclusion, this review synthesizes current knowledge, positioning
erythropoietin as a promising intervention for managing anemia in individuals living with HIV.
Keywords: erythropoietin, anemia, HIV
Introduction
Anemia represents a formidable challenge in the landscape of HIV/AIDS, exerting a profound
impact on the health and well-being of affected individuals.1-2 Despite significant advancements
in antiretroviral therapy (ART), anemia remains a prevalent and complex complication,
Elite Journal of Scientific Research and Review. Volume 2 issue 1(2024), Pp. 24-36
https://epjournals.com/journals/EJSRR
Citation: Obeagu EI, Obeagu, GU. The Crucial Role of Erythropoietin in Managing Anemia in
HIV: A Review. Elite Journal of Scientific Research and Review, 2024; 2(1): 24-36
2
contributing to a myriad of health-related issues. The etiology of anemia in the context of HIV is
multifactorial, encompassing chronic inflammation, immune dysregulation, opportunistic
infections, and the adverse effects of therapeutic interventions. As individuals living with HIV
experience improved longevity with the advent of effective antiretroviral treatments, the burden
of anemia has become more pronounced, necessitating a nuanced understanding and targeted
interventions for comprehensive patient care.3-12
Erythropoietin (EPO), a glycoprotein hormone intricately involved in the regulation of red blood
cell production, emerges as a potential cornerstone in the management of HIV-associated anemia.
This review seeks to unravel the multifaceted relationship between HIV, anemia, and
erythropoietin, shedding light on the physiological intricacies that underlie the hematologic
challenges faced by individuals with HIV/AIDS. Understanding the mechanisms by which anemia
develops in the context of HIV is fundamental to delineating the role of erythropoietin in its
management. Chronic inflammation, a hallmark of HIV, not only contributes to anemia but also
disrupts the finely tuned balance of erythropoiesis, further exacerbating hematologic
complications.13-23 The regulation of erythropoietin, both endogenously and exogenously, plays a
pivotal role in maintaining homeostasis within the hematopoietic system. As HIV disrupts this
delicate equilibrium, exploring the impact of the virus on endogenous EPO production becomes
imperative. This exploration aims to uncover potential therapeutic targets and strategies to
modulate erythropoiesis, offering a more nuanced approach to managing anemia in individuals
living with HIV. Moreover, the adverse effects of antiretroviral therapy, including potential bone
marrow toxicity, underscore the need for targeted interventions such as erythropoietin
supplementation to alleviate the burden of anemia while ensuring optimal HIV management.24-34
In light of the ongoing efforts to improve the quality of life for individuals living with HIV, this
review critically examines clinical studies evaluating the efficacy and safety of exogenous
erythropoietin supplementation in the context of HIV-associated anemia. By synthesizing current
evidence, this review aims to provide clinicians with valuable insights into optimal dosages,
treatment durations, and potential challenges associated with incorporating erythropoietin into the
comprehensive care of HIV patients with anemia. Additionally, recognizing the frequent
coexistence of iron deficiency in HIV-related anemia, this review explores the intricate interplay
between erythropoietin supplementation and strategies to address iron deficiency, ensuring a
holistic and effective therapeutic approach.
Mechanism of Anemia in HIV
The mechanism of anemia in individuals living with HIV is multifaceted, involving a complex
interplay of various factors that disrupt the delicate balance of erythropoiesis and hemoglobin
production. Understanding the intricacies of this process is crucial for developing targeted
interventions to effectively manage anemia in the context of HIV. The primary mechanisms
contributing to anemia in HIV include chronic inflammation, immune dysregulation, direct viral
effects, opportunistic infections, and adverse effects of antiretroviral therapy (ART). Chronic
inflammation is a hallmark of HIV infection, leading to the release of proinflammatory cytokines
such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α). These cytokines play a
Elite Journal of Scientific Research and Review. Volume 2 issue 1(2024), Pp. 24-36
https://epjournals.com/journals/EJSRR
Citation: Obeagu EI, Obeagu, GU. The Crucial Role of Erythropoietin in Managing Anemia in
HIV: A Review. Elite Journal of Scientific Research and Review, 2024; 2(1): 24-36
3
pivotal role in disrupting the normal functioning of the bone marrow and impairing erythropoiesis.
The inflammatory milieu inhibits the response to erythropoietin, the hormone responsible for
stimulating red blood cell production, thereby contributing to anemia. HIV infection results in
profound immune dysregulation, affecting various components of the immune system.
Dysfunctional immune cells, particularly T lymphocytes, can directly impact erythropoiesis by
altering the microenvironment within the bone marrow. This dysregulation contributes to
ineffective erythropoiesis and compromises the production of mature red blood cells.35-54
The HIV virus itself may have direct effects on hematopoietic stem cells and progenitor cells in
the bone marrow. Viral proteins and genetic elements may interfere with the normal differentiation
and maturation of red blood cells, leading to reduced erythrocyte production and, consequently,
anemia. Opportunistic infections, common in individuals with compromised immune systems due
to HIV, can exacerbate anemia. Infections such as Mycobacterium avium complex (MAC) and
cytomegalovirus (CMV) can directly affect the bone marrow, leading to decreased red blood cell
production and increased destruction, further contributing to anemia. While ART has significantly
improved the prognosis and life expectancy of individuals with HIV, certain antiretroviral drugs
can have adverse effects on the bone marrow. Zidovudine (AZT), for instance, has been associated
with bone marrow suppression, causing anemia as a side effect.55-64
Erythropoietin: Physiology and Regulation
Erythropoietin (EPO), a glycoprotein hormone crucial for the regulation of red blood cell
production, plays a central role in maintaining the delicate balance of oxygen transport within the
body. Produced primarily in the kidneys and to a lesser extent in the liver, EPO orchestrates a
tightly regulated process known as erythropoiesis, ensuring the continuous renewal of red blood
cells to meet the body's oxygen demands. The synthesis of EPO is intricately linked to the body's
oxygen-sensing mechanisms. In response to hypoxia, or low oxygen levels, specialized cells in the
kidneys, known as peritubular fibroblasts, release EPO. This hypoxia-driven release is mediated
by the stabilization of hypoxia-inducible factor (HIF), a transcription factor that upregulates EPO
gene expression. Consequently, EPO is released into the bloodstream, where it exerts its effects
on the bone marrow, stimulating the production and maturation of erythrocyte precursors. The
physiological regulation of EPO extends beyond oxygen sensing. Various factors, including
anemia, blood loss, and certain medical conditions, can also trigger EPO release. This
responsiveness allows the body to adapt swiftly to changes in oxygen availability or blood volume,
maintaining a homeostatic environment.65-79
Once released, EPO binds to its receptor, the erythropoietin receptor (EPOR), located on the
surface of erythroid progenitor cells in the bone marrow. This binding event activates intracellular
signaling cascades, ultimately promoting the survival, proliferation, and differentiation of
erythroid progenitor cells. As a result, the production of mature red blood cells is enhanced,
replenishing the circulating pool and ensuring an adequate supply for oxygen transport. The
regulation of EPO extends beyond the kidneys and liver. Other tissues, including the brain and
skeletal muscles, have been identified as sites of EPO production, especially during conditions of
Elite Journal of Scientific Research and Review. Volume 2 issue 1(2024), Pp. 24-36
https://epjournals.com/journals/EJSRR
Citation: Obeagu EI, Obeagu, GU. The Crucial Role of Erythropoietin in Managing Anemia in
HIV: A Review. Elite Journal of Scientific Research and Review, 2024; 2(1): 24-36
4
stress or injury. While the primary role of EPO is erythropoiesis, emerging research suggests
additional functions, including neuroprotection and tissue repair.65
The Impact of HIV on Erythropoietin Production
HIV, a complex and dynamic retrovirus, not only targets the immune system but also exerts
profound effects on various physiological processes, including erythropoiesis and the regulation
of erythropoietin (EPO).80 HIV can directly influence EPO production through its interaction with
different cell types involved in erythropoiesis. Studies suggest that HIV may infect and disrupt the
function of renal interstitial cells responsible for EPO synthesis. This direct viral effect on renal
cells can lead to a decrease in EPO production, contributing to anemia in HIV patients. HIV
infection induces a persistent state of chronic inflammation, characterized by elevated levels of
pro-inflammatory cytokines. This inflammatory milieu can negatively impact EPO production by
disrupting the normal regulatory pathways. Interferon-gamma, a key player in the immune
response against HIV, has been shown to suppress EPO synthesis, further exacerbating anemia in
individuals with HIV. The immune activation and dysregulation associated with HIV infection
contribute to the disruption of erythropoiesis. Altered immune function may lead to the destruction
of red blood cell precursors, reducing the pool of cells available for maturation in response to EPO
signaling. Additionally, the impaired bone marrow microenvironment due to HIV-induced
changes may compromise the efficacy of EPO in stimulating erythropoiesis. While ART has
revolutionized the management of HIV, certain antiretroviral drugs may have direct or indirect
effects on EPO production. Some medications may contribute to bone marrow toxicity or interfere
with renal function, impacting the synthesis and release of EPO. Understanding the specific effects
of different ART regimens on EPO dynamics is essential for optimizing the overall care of HIV
patients with anemia. HIV infection can disrupt iron metabolism, leading to functional iron
deficiency, even in the presence of normal iron stores. Adequate iron availability is crucial for the
effectiveness of EPO in promoting erythropoiesis. The altered iron dynamics in HIV further
contribute to the complexities of anemia in this population.81-92
Addressing Iron Deficiency in HIV-Related Anemia
Iron deficiency is a prevalent and often complicating factor in the landscape of anemia among
individuals living with HIV.93 The interplay between HIV infection and iron metabolism can result
in functional iron deficiency, even when iron stores appear sufficient. Addressing iron deficiency
is paramount for the effective management of anemia in this population and requires a
comprehensive approach that considers the unique challenges posed by both HIV and iron
dynamics. Accurately diagnosing iron deficiency in HIV patients can be challenging due to the
influence of inflammation on traditional biomarkers such as serum ferritin and transferrin
saturation. In the presence of chronic inflammation, these markers may not accurately reflect the
body's iron status. Advanced diagnostic tools, including soluble transferrin receptor (sTfR) and
reticulocyte hemoglobin content (CHr), may offer more reliable insights into iron deficiency in the
context of HIV. Oral iron supplementation is often hindered by issues such as gastrointestinal
intolerance and poor absorption, which can be exacerbated in HIV patients. Intravenous iron
supplementation emerges as a more effective and well-tolerated option. This approach allows for
Elite Journal of Scientific Research and Review. Volume 2 issue 1(2024), Pp. 24-36
https://epjournals.com/journals/EJSRR
Citation: Obeagu EI, Obeagu, GU. The Crucial Role of Erythropoietin in Managing Anemia in
HIV: A Review. Elite Journal of Scientific Research and Review, 2024; 2(1): 24-36
5
the direct delivery of iron to the reticuloendothelial system and bone marrow, bypassing the
gastrointestinal tract and mitigating concerns related to absorption.
Since inflammation is a hallmark of HIV infection, it is crucial to interpret iron parameters in the
context of the inflammatory state.94 Hepcidin, a key regulator of iron metabolism, is often
upregulated in chronic inflammation, leading to decreased iron absorption and impaired release
from iron stores. Addressing inflammation through antiretroviral therapy (ART) and other anti-
inflammatory measures can positively impact iron metabolism and enhance the effectiveness of
iron supplementation. Certain antiretroviral drugs may impact iron metabolism, contributing to
anemia. Integrating ART regimens that are less likely to disrupt iron dynamics can help mitigate
iron-related complications. Close monitoring of the effects of specific antiretroviral medications
on iron metabolism is essential for tailoring treatment strategies. In addition to iron
supplementation, optimizing nutritional status is crucial for addressing anemia in individuals with
HIV. Adequate intake of vitamins and minerals, including vitamin B12 and folic acid, is essential
for erythropoiesis. A balanced and nutrient-rich diet complements iron interventions, promoting
overall hematologic health. The management of iron deficiency in HIV-related anemia necessitates
a collaborative approach involving hematologists, infectious disease specialists, and nutritionists.
Regular monitoring of iron parameters and responsiveness to interventions ensures that the chosen
strategies effectively address iron deficiency while considering the broader healthcare needs of the
individual.
Conclusion
The intricate relationship between HIV infection and anemia, coupled with the crucial role of
erythropoietin (EPO) and the complexities of iron deficiency, necessitates a comprehensive and
nuanced approach to management. Anemia remains a significant challenge in individuals living
with HIV, impacting not only their quality of life but also posing potential barriers to the
effectiveness of antiretroviral therapy and overall health outcomes. Erythropoietin emerges as a
promising adjunctive therapeutic strategy, offering the potential to address the dysregulation of
erythropoiesis inherent in HIV-related anemia. Understanding the mechanisms by which HIV
influences EPO production provides valuable insights into the pathophysiology of anemia,
enabling the development of targeted interventions to restore effective erythropoiesis.
Moreover, the coexistence of iron deficiency in HIV-related anemia adds a layer of complexity to
its management. Accurate diagnosis, considering the impact of inflammation on traditional iron
markers, and the integration of intravenous iron supplementation represent critical components of
a holistic approach. The optimization of antiretroviral therapy and nutritional interventions further
contribute to the multifaceted care required for individuals facing the dual challenges of HIV and
anemia.
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Elite Journal of Scientific Research and Review. Volume 2 issue 1(2024), Pp. 24-36
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Citation: Obeagu EI, Obeagu, GU. The Crucial Role of Erythropoietin in Managing Anemia in
HIV: A Review. Elite Journal of Scientific Research and Review, 2024; 2(1): 24-36
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Citation: Obeagu EI, Obeagu, GU. The Crucial Role of Erythropoietin in Managing Anemia in
HIV: A Review. Elite Journal of Scientific Research and Review, 2024; 2(1): 24-36
7
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Citation: Obeagu EI, Obeagu, GU. The Crucial Role of Erythropoietin in Managing Anemia in
HIV: A Review. Elite Journal of Scientific Research and Review, 2024; 2(1): 24-36
8
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Elite Journal of Scientific Research and Review. Volume 2 issue 1(2024), Pp. 24-36
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Citation: Obeagu EI, Obeagu, GU. The Crucial Role of Erythropoietin in Managing Anemia in
HIV: A Review. Elite Journal of Scientific Research and Review, 2024; 2(1): 24-36
9
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HIV/AIDS. Int. J. Adv. Res. Biol. Sci. 2023;10(9):135-142.DOI:
10.22192/ijarbs.2023.10.09.015 links/6516faa61e2386049de5e828/A-Review-of-
knowledge-attitudes-and-socio-demographic-factors-associated-with-non-adherence-to-
antiretroviral-therapy-among-people-living-with-HIV-AIDS.pdf
43. Obeagu EI, Onuoha EC. Tuberculosis among HIV Patients: A review of Prevalence and
Associated Factors. Int. J. Adv. Res. Biol. Sci. 2023;10(9):128-134.DOI:
10.22192/ijarbs.2023.10.09.014 links/6516f938b0df2f20a2f8b0e0/Tuberculosis-among-
HIV-Patients-A-review-of-Prevalence-and-Associated-Factors.pdf.
44. Obeagu EI, Ibeh NC, Nwobodo HA, Ochei KC, Iwegbulam CP. Haematological indices of
malaria patients coinfected with HIV in Umuahia. Int. J. Curr. Res. Med. Sci.
2017;3(5):100-104.DOI: 10.22192/ijcrms.2017.03.05.014
https://www.academia.edu/download/54317126/Haematological_indices_of_malaria_pati
ents_coinfected_with_HIV.pdf
45. Jakheng SP, Obeagu EI, Abdullahi IO, Jakheng EW, Chukwueze CM, Eze GC, Essien UC,
Madekwe CC, Madekwe CC, Vidya S, Kumar S. Distribution Rate of Chlamydial Infection
According to Demographic Factors among Pregnant Women Attending Clinics in Zaria
Metropolis, Kaduna State, Nigeria. South Asian Journal of Research in Microbiology.
2022;13(2):26-31.
46. Viola N, Kimono E, Nuruh N, Obeagu EI. Factors Hindering Elimination of Mother to
Child Transmission of HIV Service Uptake among HIV Positive Women at Comboni
Hospital Kyamuhunga Bushenyi District. Asian Journal of Dental and Health Sciences.
2023;3(2):7-14. http://ajdhs.com/index.php/journal/article/view/39.
47. Okorie HM, Obeagu Emmanuel I, Okpoli Henry CH, Chukwu Stella N. Comparative study
of enzyme linked immunosorbent assay (Elisa) and rapid test screening methods on HIV,
Hbsag, Hcv and Syphilis among voluntary donors in. Owerri, Nigeria. J Clin Commun
Med. 2020;2(3):180-183.DOI: DOI: 10.32474/JCCM.2020.02.000137
links/5f344530458515b7291bd95f/Comparative-Study-of-Enzyme-Linked-
Immunosorbent-Assay-ElISA-and-Rapid-Test-Screening-Methods-on-HIV-HBsAg-
HCV-and-Syphilis-among-Voluntary-Donors-in-Owerri-Nigeria.pdf.
48. Ezugwu UM, Onyenekwe CC, Ukibe NR, Ahaneku JE, Onah CE, Obeagu EI, Emeje PI,
Awalu JC, Igbokwe GE. Use of ATP, GTP, ADP and AMP as an Index of Energy
Utilization and Storage in HIV Infected Individuals at NAUTH, Nigeria: A Longitudinal,
Prospective, Case-Controlled Study. Journal of Pharmaceutical Research International.
2021;33(47A):78-84.
Elite Journal of Scientific Research and Review. Volume 2 issue 1(2024), Pp. 24-36
https://epjournals.com/journals/EJSRR
Citation: Obeagu EI, Obeagu, GU. The Crucial Role of Erythropoietin in Managing Anemia in
HIV: A Review. Elite Journal of Scientific Research and Review, 2024; 2(1): 24-36
10
49. Emannuel G, Martin O, Peter OS, Obeagu EI, Daniel K. Factors Influencing Early
Neonatal Adverse Outcomes among Women with HIV with Post Dated Pregnancies
Delivering at Kampala International University Teaching Hospital, Uganda. Asian Journal
of Pregnancy and Childbirth. 2023 Jul 29;6(1):203-211.
http://research.sdpublishers.net/id/eprint/2819/.
50. Igwe MC, Obeagu EI, Ogbuabor AO, Eze GC, Ikpenwa JN, Eze-Steven PE. Socio-
Demographic Variables of People Living with HIV/AIDS Initiated on ART in 2014 at
Tertiary Health Institution in Enugu State. Asian Journal of Research in Infectious
Diseases. 2022;10(4):1-7.
51. Vincent CC, Obeagu EI, Agu IS, Ukeagu NC, Onyekachi-Chigbu AC. Adherence to
Antiretroviral Therapy among HIV/AIDS in Federal Medical Centre, Owerri. Journal of
Pharmaceutical Research International. 2021;33(57A):360-368.
52. Igwe MC, Obeagu EI, Ogbuabor AO. ANALYSIS OF THE FACTORS AND
PREDICTORS OF ADHERENCE TO HEALTHCARE OF PEOPLE LIVING WITH
HIV/AIDS IN TERTIARY HEALTH INSTITUTIONS IN ENUGU STATE. Madonna
University journal of Medicine and Health Sciences. 2022;2(3):42-57.
https://madonnauniversity.edu.ng/journals/index.php/medicine/article/view/75.
53. Madekwe CC, Madekwe CC, Obeagu EI. Inequality of monitoring in Human
Immunodeficiency Virus, Tuberculosis and Malaria: A Review. Madonna University
journal of Medicine and Health Sciences. 2022;2(3):6-15.
https://madonnauniversity.edu.ng/journals/index.php/medicine/article/view/69
54. Echendu GE, Vincent CC, Ibebuike J, Asodike M, Naze N, Chinedu EP, Ohale B, Obeagu
EI. WEIGHTS OF INFANTS BORN TO HIV INFECTED MOTHERS: A
PROSPECTIVE COHORT STUDY IN FEDERAL MEDICAL CENTRE, OWERRI, IMO
STATE. European Journal of Pharmaceutical and Medical Research, 2023; 10(8): 564-568
55. Nwosu DC, Nwanjo HU, Okolie NJ, Ikeh K, Ajero CM, Dike J, Ojiegbe GC, Oze GO,
Obeagu EI, Nnatunanya I, Azuonwu O. BIOCHEMICAL ALTERATIONS IN ADULT
HIV PATIENTS ON ANTIRETRQVIRAL THERAPY. World Journal of Pharmacy and
Pharmaceutical Sciences, 2015; 4(3): 153-160.
links/5a4fd0500f7e9bbc10526b38/BIOCHEMICAL-ALTERATIONS-IN-ADULT-HIV-
PATIENTS-ON-ANTIRETRQVIRAL-THERAPY.pdf.
56. Obeagu EI, Obeagu GU. Effect of CD4 Counts on Coagulation Parameters among HIV
Positive Patients in Federal Medical Centre, Owerri, Nigeria. Int. J. Curr. Res. Biosci. Plant
Biol. 2015;2(4):45-49.
57. Obeagu EI, Nwosu DC. Adverse drug reactions in HIV/AIDS patients on highly active
antiretro viral therapy: a review of prevalence. Int. J. Curr. Res. Chem. Pharm. Sci.
2019;6(12):45-8.DOI: 10.22192/ijcrcps.2019.06.12.004
links/650aba1582f01628f0335795/Adverse-drug-reactions-in-HIV-AIDS-patients-on-
highly-active-antiretro-viral-therapy-a-review-of-prevalence.pdf.
58. Obeagu EI, Scott GY, Amekpor F, Obeagu GU. Implications of CD4/CD8 ratios in Human
Immunodeficiency Virus infections. Int. J. Curr. Res. Med. Sci. 2023;9(2):6-13.DOI:
10.22192/ijcrms.2023.09.02.002 links/645a4a462edb8e5f094ad37c/Implications-of-CD4-
CD8-ratios-in-Human-Immunodeficiency-Virus-infections.pdf.
Elite Journal of Scientific Research and Review. Volume 2 issue 1(2024), Pp. 24-36
https://epjournals.com/journals/EJSRR
Citation: Obeagu EI, Obeagu, GU. The Crucial Role of Erythropoietin in Managing Anemia in
HIV: A Review. Elite Journal of Scientific Research and Review, 2024; 2(1): 24-36
11
59. Obeagu EI, Ochei KC, Okeke EI, Anode AC. Assessment of the level of haemoglobin and
erythropoietin in persons living with HIV in Umuahia. Int. J. Curr. Res. Med. Sci.
2016;2(4):29-33. links/5711c47508aeebe07c02496b/Assessment-of-the-level-of-
haemoglobin-and-erythropoietin-in-persons-living-with-HIV-in-Umuahia.pdf.
60. Ifeanyi OE, Obeagu GU. The Values of CD4 Count, among HIV Positive Patients in FMC
Owerri. Int. J. Curr. Microbiol. App. Sci. 2015;4(4):906-910.
https://www.academia.edu/download/38320134/Obeagu_Emmanuel_Ifeanyi_and_Obeag
u__Getrude_Uzoma.EMMA2.pdf.
61. Obeagu EI, Okeke EI, Anonde Andrew C. Evaluation of haemoglobin and iron profile
study among persons living with HIV in Umuahia, Abia state, Nigeria. Int. J. Curr. Res.
Biol. Med. 2016;1(2):1-5.
62. Alum EU, Ugwu OP, Obeagu EI, Okon MB. Curtailing HIV/AIDS Spread: Impact of
Religious Leaders. Newport International Journal of Research in Medical Sciences
(NIJRMS). 2023;3(2):28-31.
63. Obeagu EI, Obeagu GU, Paul-Chima UO. Stigma Associated With HIV. AIDS: A Review.
Newport International Journal of Public Health and Pharmacy (NIJPP). 2023;3(2):64-67.
64. Alum EU, Obeagu EI, Ugwu OP, Aja PM, Okon MB. HIV Infection and Cardiovascular
diseases: The obnoxious Duos. Newport International Journal of Research in Medical
Sciences (NIJRMS). 2023;3(2):95-99.
65. Obeagu EI, Okoroiwu IL, Azuonwu O. An update on hypoxic regulation of iron
homeostasis and bone marrow environment. Int. J. Curr. Res. Med. Sci. 2018;4(10):42-8.
66. Obeagu EI. Blood Transfusion: A Powerful Process of Saving Anaemic Patients. EC
Emergency Medicine and Critical Care. 2020;4(7):33-40.
67. Obeagu EI, Obeagu GU. Platelet Distribution Width (PDW) as a Prognostic Marker for
Anemia Severity in HIV Patients: A Comprehensive Review. Journal home page:
http://www. journalijiar. com.;12(01).
68. Obeagu EI, Obeagu GU, Obiezu J, Ezeonwumelu C, Ogunnaya FU, Ngwoke AO, Emeka-
Obi OR, Ugwu OP. Hematologic Support in HIV Patients: Blood Transfusion Strategies
and Immunological Considerations. APPLIED SCIENCES (NIJBAS). 2023;3(3).
69. Ibebuike JE, Nwokike GI, Nwosu DC, Obeagu EI. A Retrospective Study on Human
Immune Deficiency Virus among Pregnant Women Attending Antenatal Clinic in Imo
State University Teaching Hospital. International Journal of Medical Science and Dental
Research, 2018; 1 (2):08-14.
https://www.ijmsdr.org/published%20paper/li1i2/A%20Retrospective%20Study%20on%
20Human%20Immune%20Deficiency%20Virus%20among%20Pregnant%20Women%2
0Attending%20Antenatal%20Clinic%20in%20Imo%20State%20University%20Teaching
%20Hospital.pdf.
70. Obeagu EI, Obarezi TN, Omeh YN, Okoro NK, Eze OB. Assessment of some
haematological and biochemical parametrs in HIV patients before receiving treatment in
Aba, Abia State, Nigeria. Res J Pharma Biol Chem Sci. 2014; 5:825-830.
71. Obeagu EI, Obarezi TN, Ogbuabor BN, Anaebo QB, Eze GC. Pattern of total white blood
cell and differential count values in HIV positive patients receiving treatment in Federal
Teaching Hospital Abakaliki, Ebonyi State, Nigeria. International Journal of Life Science,
Biotechnology and Pharama Research. 2014; 391:186-189.
Elite Journal of Scientific Research and Review. Volume 2 issue 1(2024), Pp. 24-36
https://epjournals.com/journals/EJSRR
Citation: Obeagu EI, Obeagu, GU. The Crucial Role of Erythropoietin in Managing Anemia in
HIV: A Review. Elite Journal of Scientific Research and Review, 2024; 2(1): 24-36
12
72. Obeagu EI. A Review of Challenges and Coping Strategies Faced by HIV/AIDS
Discordant Couples. Madonna University journal of Medicine and Health Sciences. 2023;
3 (1): 7-12.
73. Oloro OH, Obeagu EI. A Systematic Review on Some Coagulation Profile in HIV
Infection. International Journal of Innovative and Applied Research. 2022;10(5):1-11.
74. Nwosu DC, Obeagu EI, Nkwuocha BC, Nwanna CA, Nwanjo HU, Amadike JN, Ezemma
MC, Okpomeshine EA, Ozims SJ, Agu GC. Alterations in superoxide dismutiase, vitamins
C and E in HIV infected children in Umuahia, Abia state. International Journal of
Advanced Research in Biological Sciences. 2015;2(11):268-271.
75. Obeagu EI, Malot S, Obeagu GU, Ugwu OP. HIV resistance in patients with Sickle Cell
Anaemia. Newport International Journal of Scientific and Experimental Sciences
(NIJSES). 2023;3(2):56-59.
76. Ifeanyi OE, Uzoma OG, Stella EI, Chinedum OK, Abum SC. Vitamin D and insulin
resistance in HIV sero positive individuals in Umudike. Int. J. Curr. Res. Med. Sci.
2018;4(2):104-108.
77. Ifeanyi OE, Leticia OI, Nwosu D, Chinedum OK. A Review on blood borne viral
infections: universal precautions. Int. J. Adv. Res. Biol. Sci. 2018;5(6):60-66.
78. Nwovu AI, Ifeanyi OE, Uzoma OG, Nwebonyi NS. Occurrence of Some Blood Borne
Viral Infection and Adherence to Universal Precautions among Laboratory Staff in Federal
Teaching Hospital Abakaliki Ebonyi State. Arch Blood Transfus Disord. 2018;1(2).
79. Chinedu K, Takim AE, Obeagu EI, Chinazor UD, Eloghosa O, Ojong OE, Odunze U. HIV
and TB co-infection among patients who used Directly Observed Treatment Short-course
centres in Yenagoa, Nigeria. IOSR J Pharm Biol Sci. 2017;12(4):70-75.
80. Vignjević Petrinović S, Jauković A, Milošević M, Bugarski D, Budeč M. Targeting stress
erythropoiesis pathways in cancer. Frontiers in Physiology. 2022; 13:844042.
81. Offie DC, Obeagu EI, Akueshi C, Njab JE, Ekanem EE, Dike PN, Oguh DN. Facilitators
and barriers to retention in HIV care among HIV infected MSM attending Community
Health Center Yaba, Lagos Nigeria. Journal of Pharmaceutical Research International.
2021;33(52B):10-19.
82. Obeagu EI, Obeagu GU, Ede MO, Odo EO, Buhari HA. Translation of HIV/AIDS
knowledge into behavior change among secondary school adolescents in Uganda: A
review. Medicine (Baltimore). 2023;102(49): e36599. doi:
10.1097/MD.0000000000036599. PMID: 38065920; PMCID: PMC10713174.
83. Anyiam AF, Arinze-Anyiam OC, Irondi EA, Obeagu EI. Distribution of ABO and rhesus
blood grouping with HIV infection among blood donors in Ekiti State Nigeria. Medicine
(Baltimore). 2023;102(47): e36342. doi: 10.1097/MD.0000000000036342. PMID:
38013335; PMCID: PMC10681551.
84. Echefu SN, Udosen JE, Akwiwu EC, Akpotuzor JO, Obeagu EI. Effect of Dolutegravir
regimen against other regimens on some hematological parameters, CD4 count and viral
load of people living with HIV infection in South Eastern Nigeria. Medicine (Baltimore).
2023;102(47): e35910. doi: 10.1097/MD.0000000000035910. PMID: 38013350; PMCID:
PMC10681510.
85. Opeyemi AA, Obeagu EI. Regulations of malaria in children with human
immunodeficiency virus infection: A review. Medicine (Baltimore). 2023;102(46):
Elite Journal of Scientific Research and Review. Volume 2 issue 1(2024), Pp. 24-36
https://epjournals.com/journals/EJSRR
Citation: Obeagu EI, Obeagu, GU. The Crucial Role of Erythropoietin in Managing Anemia in
HIV: A Review. Elite Journal of Scientific Research and Review, 2024; 2(1): 24-36
13
e36166. doi: 10.1097/MD.0000000000036166. PMID: 37986340; PMCID:
PMC10659731.
86. Alum EU, Obeagu EI, Ugwu OPC, Samson AO, Adepoju AO, Amusa MO. Inclusion of
nutritional counseling and mental health services in HIV/AIDS management: A paradigm
shift. Medicine (Baltimore). 2023;102(41): e35673. doi: 10.1097/MD.0000000000035673.
PMID: 37832059; PMCID: PMC10578718.
87. Aizaz M, Abbas FA, Abbas A, Tabassum S, Obeagu EI. Alarming rise in HIV cases in
Pakistan: Challenges and future recommendations at hand. Health Sci Rep. 2023;6(8):
e1450. doi: 10.1002/hsr2.1450. PMID: 37520460; PMCID: PMC10375546.
88. Obeagu EI, Obeagu GU, Obiezu J, Ezeonwumelu C, Ogunnaya FU, Ngwoke AO, Emeka-
Obi OR, Ugwu OP. Hematologic Support in HIV Patients: Blood Transfusion Strategies
and Immunological Considerations. APPLIED SCIENCES (NIJBAS). 2023;3(3).
89. Obeagu EI, Ubosi NI, Uzoma G. Storms and Struggles: Managing HIV Amid Natural
Disasters. Int. J. Curr. Res. Chem. Pharm. Sci. 2023;10(11):14-25.
90. Obeagu EI, Obeagu GU. Human Immunodeficiency Virus and tuberculosis infection: A
review of prevalence of associated factors. Int. J. Adv. Multidiscip. Res. 2023;10(10):56-
62.
91. Obeagu EI, Malot S, Obeagu GU, Ugwu OP. HIV resistance in patients with Sickle Cell
Anaemia. Newport International Journal of Scientific and Experimental Sciences
(NIJSES). 2023;3(2):56-9.
92. Alum EU, Ugwu OP, Obeagu EI, Aja PM, Okon MB, Uti DE. Reducing HIV Infection
Rate in Women: A Catalyst to reducing HIV Infection pervasiveness in Africa.
International Journal of Innovative and Applied Research. 2023;11(10):01-6.
93. Obeagu EI, Obeagu GU, Ukibe NR, Oyebadejo SA. Anemia, iron, and HIV: decoding the
interconnected pathways: A review. Medicine. 2024;103(2): e36937.
94. Demitto FO, Araújo-Pereira M, Schmaltz CA, Sant’Anna FM, Arriaga MB, Andrade BB,
Rolla VC. Impact of persistent anemia on systemic inflammation and tuberculosis
outcomes in persons living with HIV. Frontiers in immunology. 2020; 11:588405.
