Can Sickle Cell Anemia Protect Against HIV?

Research suggests sickle cell anemia may offer some protection against HIV and may also slow HIV progression. However, experts still need further research to understand why this occurs.

Sickle cell anemia is part of a group of inherited blood disorders called sickle cell disease (SCD). It changes the shape of your red blood cells and causes them to move stiffly through the bloodstream.

Research suggests SCD may offer some protection against HIV transmissions. Experts don’t fully understand the reasons for this, but it could be partly due to how SCD alters the immune system.

What is understood is people with SCD are reported to have low rates of HIV transmissions, slower progression to AIDS, and lower rates of HIV-related mortality than people without SCD.

Can sickle cell anemia protect against HIV?

Research shows sickle cell anemia may be protective against HIV and may also slow HIV progression.

In several different studies, people with sickle cell disease (SCD) had significantly reduced levels of HIV transmission. In people who had SCD along with HIV, people with SCD also experienced minimal HIV disease progression.

A 2022 study tracked HIV patients in Nigeria and found the sickle cell trait could only be associated with the severity of HIV transmissions in females.

Another study from 2020 looked at the lower rate of HIV transmissions in SCD patients who had received blood transfusions before standardized HIV screening protocols. While the study could not confirm how or why SCD patients had lower transmission rates, there was a lower prevalence of HIV in SCD subjects.

Researchers are still learning why people with SCD have protection against HIV, but current theories include:

• Autosplenectomy: People with SCD often have reduced spleen function. The spleen plays an important role in immune function. It seems autosplenectomy lowers the viral load of HIV in people with SCD. However, the reduced spleen function also makes SCD subjects more vulnerable to serious infections.
• Reduced CCR5 expression: CCR5 is a protein in white blood cells involved in the immune system and HIV transmission. Its reduced expression in people with SCD protects certain cells from infection.
• Increased heme and iron-regulated genes: Iron plays an important role in HIV transmission. The increase in certain iron-regulated genes in people with SCD has been shown to restrict HIV transmission.

How can you reduce the risk of getting HIV?

HIV is a preventable disease. You can reduce your risk of contracting HIV by:

• Knowing your status: Get tested regularly for HIV.
• Practicing safe sex: Use condoms correctly every time you have sex, regardless of who you are having sex with.
• Not injecting drugs: If you do, only use sterile equipment and never share with others.
• Taking PrEP if you are at risk: Taking a preexposure prophylaxis (PrEP) medication can reduce your chances of contracting HIV if you engage in HIV-risky behaviors.
• Protecting others if you have HIV: If you are HIV-positive, it is important to stick to your antiretroviral therapy (ART) medication regimen to reduce your risk of spreading HIV to others.
• Preventing perinatal transmission: If you are HIV-positive and pregnant, there are medications you can take to significantly reduce your risk of transmitting HIV to the fetus.

How can HIV be treated?

There is no cure for HIV, but current treatment methods can reduce HIV in your body to near-undetectable levels. HIV treatment is most successful if you start soon after a doctor diagnoses you, and you will need to continue treatment for life.

The current standard of HIV treatment is called antiretroviral therapy (ART), which is a combination of medications taken daily. ART is recommended for any HIV-positive person. It can reduce the levels of HIV in your body to an undetectable level and reduce the risk of HIV transmission to another person.

ART works by preventing HIV from multiplying in the body. This gives the immune system a chance to recover and produce CD4 cells . CD4 cells are the infection-fighting part of your immune system that HIV attacks and destroys. With more CD4 cells, the immune system can become strong enough to fight off infections.

What should people with HIV avoid?

Maintaining a healthy lifestyle is important for living well with HIV. While a healthy and balanced diet plays a significant role in this, people with HIV have a weakened immune system, making them more vulnerable to serious reactions from foodborne illnesses.

To prevent this, people with HIV should avoid :

• any raw or undercooked eggs
• unpasteurized dairy products
• raw or undercooked meat or seafood

When it comes to food preparation, continue to keep food safety in mind:

• clean your hands, utensils, and surfaces while preparing foods
• separate different foods to prevent cross contamination
• cook all foods to safe temperatures
• refrigerate or freeze any perishable foods within 2 hours of purchasing or preparing

Support for HIV

If you are living with HIV, there are many ways to find information and support, including:

• HIV.gov
• National Institute of Health
• Ryan White HIV/AIDS Program
• CDC’s Let’s Stop HIV Together
• Advocacy organizations

Frequently asked questions

Which disease is closely linked to HIV?

HIV is closely linked to other conditions, such as hepatitis B and hepatitis C. It can also increase the risk of both conditions.

Is anemia an early symptom of HIV?

Anemia can often be an early symptom of HIV due to chronic inflammation and decreased red blood cell production from the virus.

What should you avoid with sickle cell anemia?

If you have sickle cell anemia, it can be beneficial to avoid strenuous activity, drinking alcohol, and smoking.

Takeaway

Sickle cell anemia is a type of sickle cell disease (SCD) that distorts red blood cells. This can lead to decreased blood flow, increased blood clot risk, frequent infections, and pain.

Though experts can’t definitively explain why yet, people with sickle cell anemia have a reduced transmission rate of HIV as well as reduced HIV progression.

HIV antiretroviral therapy is the current treatment standard for people with HIV, and it may reduce the HIV viral load to undetectable levels. If you have sickle cell anemia and are HIV-positive, serious progression of HIV is unlikely.