Prevalence of anemia among HIV-infected individuals and the associated factors: A single-center, retrospective review of 513 cases

Abstract

Background: Although a major public health problem around the world, the prevalence of anemia and the associated factors in HIV-infected individuals remains understudied in the Indian context. Objectives: The objective was to assess the prevalence of anemia and the associated factors among HIV-infected individuals. Methods: The records of 513 HIV-affected individuals (M: F: 244:269) aged 12 to 84 years (mean ± SD: 37.5 ± 12.1) were reviewed retrospectively for the presence of anemia and the associated factors. The anemia was defined and severity was graded per the WHO guidelines. Results: Anemia of variable severity was present in 77.7% of the individuals. The female sex(OR: 2.09; Cl: 95%; CI: 1.41–3.10; p < 0.05), CD4+ count ≤ 200 cells/microliter (OR: 2.36; Cl: 95%; CI: 1.59–3.52; p < 0.0001), WBC count < 4000 cells/mm3 (OR: 3.29; Cl: 95%; CI: 0.97–11.14; p < 0.04), platelet count < 100,000 cells/dL (OR: 0.50; Cl: 95%; CI: 0.31–0.81; p < 0.05), before ART (OR: 3.78; Cl: 95%; CI: 2.91–4.91; p < 0.0001), and tuberculosis treatment (OR: 5.88; Cl: 95%; CI: 1.38–25.04; p < 0.05) were factors significantly associated with anemia. The mean duration of highly active antiretroviral therapy (ART) was 3.15 years, with 395 (77%) individuals being on treatment for ≤ five years. ART significantly improved hemoglobin levels (p < 0.0001). Conclusion: Anemia of variable severity remains a significant co-morbidity among HIV-infected individuals, especially females, prior to the initiation of ART, and those with a low CD4+ count or thrombocytopenia and on anti-tuberculosis treatment. The fact that this was a single-center study, its small number of subjects, the retrospective design, and no information on red blood cell indices and the viral load were its important limitations. Key words: AIDS; anemia; ART; CD4+ count; HAART; HIV; India