Prevalence and determinants of anemia amongst HIV positive pregnant women in a tertiary Hospital in Nigeria

Abstract

Background: In pregnancy, anemia is associated with increased risk of both maternal and fetal morbidity and mortality especially in HIV situation. To determine the prevalence and determinants of anemia in HIV positive compared to HIV negative women.Methods: This was a cross sectional study carried out from June 2016 to December 2017 amongst pregnant women who presented to the antenatal clinic. Information on socio-demographic variables and laboratory test to determine the hemoglobin levels and CD4 count (for the HIV positive women) were carried out. A total of 350 subjects with equal number of HIV positive and HIV negative pregnant women were recruited. Variables were compared between the two groups using software package for social sciences version 20. P values<0.05 at 95% confidence interval are considered statistically significant.Results: The mean age for HIV positive and negative were 31.54 ±4.1 and 29.03 respectively while, mean gestational age at booking for HIV positive and negative were 20.41±8.61 and 22.37±7.4 weeks respectively. The HIV positive group had a mean parity of 2.02±1.5, and 2.56±1.2 was that of the HIV negative group. The mean hemoglobin statuses at booking were 9.92±1.8 g/dl and 10.6±1.1 g/df HIV positive and HIV negative women respectively. The mean CD4+ at booking for HIV positive group was 478±251 per microliter. The overall prevalence of anemia irrespective of HIV status was 36.6%. The prevalence of anemia in HIV positive and negative women were 44.6% and 28.6% respectively. There was statistically significant relationship between anemia and HIV status (p=0.002).Conclusions: There was inverse relationship between CD4+ count and anemia. Low CD4+ count and non-use of HAART at booking were important determinants of anemia among the HIV.

Prevalence of anemia and associated factors among patients living with HIV/AIDS at Mizan-Tepi University Teaching Hospital, Southwest Ethiopia

“…Studies from different countries consider anemia a common problem for HIV/AIDS patients, making their life miserable: India (51.9%, 164/316) [23], China (55.15%, 255/462) [24], Indonesia with HAART-naïve and patients on HAART as 60.8% and 40.3%, respectively [25], Nepal (66.7%, 140/210) [26], and Uganda (67.38%, 95/141) [27]. In the above-mentioned studies, the rates of prevalence were much higher as compared with the finding of the present study, and other research showed relative lower findings, even though the number of patients included in the respective studies differed: Nigeria (36.6%, 128/350) [28], Northwest Ethiopia (16.2%, 43/265) [29], South Ethiopia (36.5%, 150/411) [30], United States (10.3%, 1,551/15,126) [31], and Ethiopia (31.0%, 2,504/8,079) [32]. The above differences in anemia prevalence might be due variations in nutritional status of patients, their family histories, diseases caused by a genetic disorder, the presence of current co-infections caused by either parasites or other diseases that can contribute to the occurrence of anemia.…”

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

“…This was comparable to 33.7% among same group of women from Jos, 44.6% from another study from Owerri, both in Nigeria, and 34.5% using Hb<10 g/dl cut-off from South Africa study. [30][31][32] The finding was however much lower than 62.6% prevalence found from Port Harcourt, 75.5% from Orlu, and 88.5% prevalence in Uyo, all from Nigeria, as well as 64.5% from South Africa, and 83.0% from Tanzania. [33][34][35][36] The high prevalence of anaemia in HIV positive pregnant women in this study could not be unconnected with multifactorial causes earlier mentioned: Direct retroviral infection of bone marrow stroma, and haematopoietic stem cells, changes in the regulation/suppression of erythropoiesis from cytokine production, and decrease in erythropoietin concentration, and indirectly from increase in apoptosis of the marrow cells in response to chronic opportunistic infections with autoimmune destruction of cells.…”