Mean corpuscular volume (MCV) values reflect therapeutic effectiveness in zidovudine-receiving HIV patients

An increase of the mean corpuscular volume (MCV) of erythrocytes and alterations in the lipid profiles have been described in HIV-infected patients under combination of anti-retroviral treatment (cART), particularly zidovudine (AZT).

In 687 sera from 179 HIV-positive patients, MCV levels were correlated with the clinical outcome or therapeutic effectiveness. The sera were classified into three groups according to AZT treatment; cART with AZT (n = 317), cART without AZT (n = 262), and no anti-retroviral therapy (n = 108).

The MCV and lipid profile values were increased after cART. The AZT-based cART group had higher MCV levels (111.6 ± 7.0 vs. 97.8 ± 7.0 fl, P < 0.001) and a higher incidence of macrocytosis (>99 fl; 95.3% vs. 38.2%, P < 0.001) than the non-AZT-based cART group. The receiver operating characteristic curve analysis showed that the area under the curve was 0.835 and the cut-off of MCV (>102 fl) had a sensitivity of 96.1% and specificity of 66.7% for detecting HIV-RNA (-) sera in AZT-based cART group. In the multivariate regression analysis, HIV-viral load and HDL-cholesterol were the only significant correlates to the MCV values in the AZT-base cART group (P < 0.05).

The MCV values could be used as a surrogate marker to monitor the clinical outcome of HIV-infected patients receiving AZT-based cART.