Anaemia in HIV‐infected pregnant women receiving triple antiretroviral combination therapy for prevention of mother‐to‐child transmission: a secondary analysis of the Kisumu breastfeeding study (KiBS)

Abstract

Abstractobjective The prevalence of anaemia during pregnancy is estimated to be 35-75% in sub-Saharan Africa and is associated with an increased risk of maternal mortality. We evaluated the frequency and factors associated with anaemia in HIV-infected women undergoing antiretroviral (ARV) therapy for prevention of mother-to-child transmission (PMTCT) enrolled in The Kisumu Breastfeeding Study 2003-2009. methods Maternal haematological parameters were monitored from 32 to 34 weeks of gestation to 2 years post-delivery among 522 enrolled women. Clinical and laboratory assessments for causes of anaemia were performed, and appropriate management was initiated. Anaemia was graded using the National Institutes of Health Division of AIDS 1994 Adult Toxicity Tables. Data were analysed using SAS software, v 9.2. The Wilcoxon two-sample rank test was used to compare groups. A logistic regression model was fitted to describe the trend in anaemia over time.results At enrolment, the prevalence of any grade anaemia (Hb < 9.4 g/dl) was 61.8%, but fell during ARV therapy, reaching a nadir (7.4%) by 6 months post-partum. A total of 41 women (8%) developed severe anaemia (Hb < 7 g/dl) during follow-up; 2 (4.9%) were hospitalised for blood transfusion, whereas 3 (7.3%) were transfused while hospitalised (for delivery). The greatest proportion of severe anaemia events occurred around delivery (48.8%; n = 20). Anaemia (Hb ≥ 7 and < 9.4 g/dl) at enrolment was associated with severe anaemia at delivery (OR 5.87; 95% CI: 4.48, 7.68, P < 0.01). Few cases of severe anaemia coincided with clinical malaria (24.4%; n = 10) and helminth (7.3%; n = 3) infections.

Knowledge, perceptions and practices of HIV-infected mothers regarding HIV and infant feeding

“…Anaemia prevalence was lower than in a study conducted in Kenya among pregnant HIV-infected women, where the prevalence of any grade of anaemia (Hb < 9.4 g/dl) was 61.8%. 20 Anaemia is the most common haematological anomaly encountered in HIV-infected patients, and has been identified as a risk factor for earlier mortality in patients with acquired immune deficiency disorder (AIDS). 21 Almost all of the mothers reported that they had easy access to HIV testing and ARVs while pregnant, which is a positive finding.…”

Adverse effects of antiretroviral therapy in pregnant women infected with HIV in Brazil from 2000 to 2015: a cohort study

“…Even when it is known that AZT is not the only cause of anemia in pregnancy, and that ART is linked to improved health, particularly in lower income countries, anemia is the most common adverse effect associated with AZT use in pregnancy, independently of the regimen [ 29 – 31 ]. A study with 1070 pregnant women in sub-Saharan Africa between 2005 and 2008 reported the same results [ 32 ].…”

Anaemia in HIV positive mothers on antiretroviral therapy for prevention of mother-to-child transmission HIV in a tertiary health institution in North Central Nigeria

“…Human immunodeficiency virus (HIV) infection and maternal anaemia are major public health problem in developing countries with extremely high prevalence in the sub Saharan Africa (SSA). 1,2 The duo occurring in pregnancy is associated with increased risk of foetomaternal morbidity and mortality. 3,4 Anaemia is said to occurs when the oxygen-carrying capacity of red blood cells is insufficient and fails to satisfy the physiologic demands of the body, and defined as haemoglobin concentration of <11.0 g/dl by WHO remains a big health challenges to safe motherhood in developing parts of Africa despite the considerable improvement in healthcare-delivery services.…”