Prevalence and correlates of anemia among HIV infected patients on highly active anti-retroviral therapy at Zewditu Memorial Hospital, Ethiopia

Abstract

BackgroundEthiopia is one of the most seriously HIV affected countries in Sub-Saharan Africa. Anemia is a known predictor of disease progression and death among HIV infected patients. In this study, we investigated the magnitude and correlates of anemia among HIV infected patients receiving HAART at a referral hospital in Ethiopia.MethodsA retrospective cohort study was conducted from November 2011 to February 2012 in Zewditu Memorial Hospital, Addis Ababa, Ethiopia. Records of 1061 patients on HAART were selected using simple random sampling technique. Socio-demographic and clinical characteristics of the study patients were collected using standardized data extraction instrument. Data were analyzed using STATA version 11.0. Odds ratios with 95% confidence intervals were used to quantify the strength of association between anemia and its potential predictors.ResultsThe prevalence of anemia at baseline was 42.9%. However, the prevalence significantly decreased to 20.9% at 6 months (p < 0.001) and to 14.3% at 12 months (p = 0.001) after HAART initiation. At baseline, male sex (AOR = 1.55; 95% CI: 1.18-2.03), clinical stage III/IV (AOR = 2.03; 95% CI: 1.45-2.83) and TB co-infection (AOR = 1.52; 95% CI: 1.08-2.13) were independently associated with the odds of being anemic. After 6 months of HAART, male sex (AOR = 1.59; 95% CI: 1.13-2.23), baseline anemia (AOR = 2.38; 95% CI: 1.71-3.33) and TDF-based HAART (AOR = 2.87; 95% CI: 1.80-4.60) were independently associated with the odds of being anemic. Besides, anemia was independently associated with older age at 6 months. After 12 months of HAART, baseline anemia (AOR = 2.01; 95% CI: 1.36-2.97), age group 25–34 years (AOR = 5.92; 95% CI: 1.39-25.15), age group 45–54 years (AOR = 4.78; 95% CI: 1.07-21.36), CD4 count below 200 cells/mm3 (AOR = 2.15; 95% CI: 1.21-3.82) and 200–350 cells/mm3 (AOR = 1.91; 95% CI: 1.13-3.25) were independently associated with the odds of being anemic.ConclusionsAlthough a remarkable reduction in the prevalence of anemia was observed following initiation of HAART, a significant proportion of HIV patients remained anemic after 12 months of HAART suggesting the need for routine screening and proper treatment of anemia to mitigate its adverse effects.

Anemia in combined antiretroviral treatment-naive HIV-infected patients in China: A retrospective study of prevalence, risk factors, and mortality

“…Lower BMI is related to malnutrition and nutrient deficiencies, including deficiencies of vitamin B12, folate, and iron, which directly result in anemia. Similar to prior findings (3,20), our results found a strong independent association between CD4 count ≤ 199 × 10 9 /L and anemia; this association was most pronounced in those with a CD4 count < 50 × 10 9 /L. We also demonstrated that higher baseline HIV viral loads were associated with anemia.…”

“…Both clinically advanced disease and low CD4 counts are associated with an increased risk of anemia (17). In China, the prevalence of anemia varies markedly between different regions (3), and mild anemia is prone to be neglected in clinical work. The prevalence of and risk factors for anemia, and the association between anemia and prognosis in HIVinfected patients are not well documented in China.…”

Prevalence of anemia and its associated factors in human immuno deficiency virus infected adult individuals in Ethiopia. A systematic review and meta-analysis

“…All the included studies were published between 2005 and 2017. Both cross sectional and cohort studies were included accordingly using an estimated sample size range from 172 [27] up to 1061 [16] adult HIV infected individual samples who were taken at Southwest parts of Ethiopia in the year 2014 and Addis Ababa city in the year 2011/2012 respectively. About 3139 men and 4920 women with a total sample of 8, 059 adult HIV infected individuals were included to estimate the pooled prevalence of anemia and its associated factors among adult HIV infected individuals (Table 1).…”

“…Based on this recommendation, a number of researches were done and reported that the prevalence of anemia among HIV infected adult individuals was:11.2% at northwest parts of Ethiopia in 2014 [3], 11.4% at Addis Ababa in 2018 [13],11.5% at northwest parts of Ethiopia in 2014 [14], 12% at southern parts of Ethiopia in 2005–2010 [15],14.3% at Addis Ababa in 2011/2012 [16], 22.6 at southern parts of Ethiopia in 2016 [17], 23%at northwest parts of Ethiopia in 2015 [18], 23.1% at Southwest parts of Ethiopia in 2012 [19], 25% at Northwest parts of Ethiopia in 2016 [20], 32.48% at Addis Ababa in 2011/2012 [21], 33% at Addis Ababa in 2008–2012 [22], 34.4% at northeast parts of Ethiopia in 2010–2013 [23], 35% at northwest Ethiopia in 2011/2012 [24], 41.2% at Eastern parts of Ethiopia in 2014 [25], 43% at northwest parts of Ethiopia in 2012/2013 [26], 51.74% at Gambella region in Southwest parts of Ethiopia in 2014 [27], 53.3% in Southern parts of Ethiopia in 2016–2013 [3] and 70.1% at northwest parts of Ethiopia in 2011/2012 [28]. …”

Adverse drug reaction in HIV-infected people treated with HAART in Maringá, Southern Brazil

“…Some of ARV drugs, such as AZT are myelosuppressive, and affect red blood cells, and therefore lead to anemia, a common manifestation of HIV infection both before and after the treatment initiation [7]. Anemia was present in 48.8 % of our patients in whom this parameter was evaluated.…”