Red cell distribution width in patients with HIV infection

Objective: To examine the association between elevated levels of red cell distribution width (RDW) and cardiovascular risk factors (CVRF) and metabolic syndrome (MS) in HIV-patients. Methods: Cross-sectional study including all asymptomatic HIV-outpatients under follow-up during 2007. Patients completed a questionnaire about CVRF, underwent a physical examination, and an 8-hour fasting blood analysis. Elevated RDW was defined as ≥75th percentile. Patients with and without an elevated RDW were compared. Results: 666 patients (79.3% men) were included: mean age 44.7 years, mean CD4 506/mm3 and 87.5% on antiretroviral therapy (85.3% with undetectable viral load). Mean RDW was 13.7% (range: 7.7% - 33.6%; 75th percentile, 14.1%). The prevalence per quartile of MS was 15.7%, 9.3%, 18.8% and 16.6% and of patients with CVRF > 20% was 8.4%, 4.0%, 4.4%, and 6.4%, respectively (p > 0.05); 23.4% of the patients had an elevated RDW (>14.1%). The top percentile of RDW was associated with AIDS (OR 1.6; 95% CI, 1.0 - 2.4; p = 0.02), detectable viral load (OR 1.5; 95% CI, 1.01 - 2.4; p = 0.04) and hypertension (OR 2.3; 95% CI, 1.4 - 4.0; p = 0.001). Conclusions: In HIV-outpatients, higher RDW is related with detectable viral load and with AIDS. Although it was associated with hypertension, we found no relation with MS nor with higher cardiovascular risk.