IMMUNOLOGICAL CHALLENGES IN TREATING PATIENTS WITH HIV AND SICKLE CELL DISEASE: A NARRATIVE REVIEW

Emmanuel Ifeanyi Obeagu; Chukwuma J. Okafor

doi:10.22270/ujpr.v10i6.1466

Emmanuel Ifeanyi Obeagu Department of Biomedical and Laboratory Science, Africa University, Mutare, Zimbabwe. The Department of Molecular Medicine and Haematology, School of Pathology, Faculty of Health Sciences, University of the Witwatersr and, Johannesburg, South Africa.
Chukwuma J. Okafor Department of Pathology and Biochemistry, State University of Zanzibar, Tanzania.

10.22270/ujpr.v10i6.1466

Keywords:

Chronic inflammation, HIV, immune dysregulation, immunologic synergy, sickle cell co-infection

Abstract

The simultaneous presence of HIV infection and sickle cell disease (SCD) poses considerable immunological and treatment difficulties, especially in areas where both conditions are very common. HIV leads to gradual immunodeficiency by depleting CD⁴⁺ T cells and causing chronic immune activation, whereas SCD is marked by ongoing inflammation, hemolysis, and weakened immune responses. These factors together result in a complicated immune environment characterized by increased inflammation, immune fatigue, and greater vulnerability to infections. This review examines the shared immune dysregulation in HIV and SCD, emphasizing the contributions of monocyte activation, T cell impairment, and endothelial damage in promoting disease complications. We examine how persistent inflammation and immune response worsen vaso-occlusive crises, coagulopathy, and blood-related issues, making clinical management more complex. Moreover, the effects of standard therapies including antiretroviral treatment and SCD-specific therapies like hydroxyurea and transfusions on immune balance are evaluated, emphasizing possible drug interactions and immune effects.