Prevalence, Severity and Relationship of Anaemia with Immune Status and Use of Highly Active Antiretroviral Therapy among Human Immunodeficiency Virus-Infected Adults in South-eastern Nigeria

Abstract

Objective: Anaemia is a significant complication of human immunodeficiency infection, causing life-threatening symptoms and impairing quality of life. This study aimed to assess the prevalence, severity and associations of anaemia, with cluster of differentiation 4 (CD4+) cell count and use of highly active antiretroviral therapy (HAART), in human immunodeficiency virus-infected patients. Material and Methods: Haemoglobin concentration, CD4+ count, HAART use and other factors were assessed in 372, adult HIV-infected out-patients; enrolled at a tertiary hospital in South-Eastern Nigeria. Anaemia was defined according to World Health Organisation criteria. Independent predictors were determined using bivariate analysis and enter method logistic regression analysis, at a p-value<0.05.Results: Prevalence of anaemia was 76.3% overall; 79.9% in females and 67.6% in males. Median CD4+ cell count was 609.50 (interquartile range 379) cells per microlitre (cells/μl). Females were more likely to be anaemic than males [odds ratio (OR)=1.88, 95% confidence interval (CI) 1.07, 3.31; p-value=0.011]. Furthermore, the odds of being anaemic were higher in participants 50 years or older (OR 3.79, 95% CI 1.36, 10.55; p-value=0.023). A CD4+ count <200 cells/μl. Not being on cotrimoxazole preventive therapy and a low monthly household income were associated with higher odds of anaemia. Tenofovir- and abacavir-based regimens were associated with lower odds of anaemia compared to zidovudine. Conclusion: Gender and the age of patients were independent predictors of anaemia. Pre-treatment screening, and close follow-up monitoring for anaemia as well as increased access to less haematotoxic HAART regimens are needed.

Prevalence, severity and associated risk factors of anemia among human immunodeficiency virus-infected adults in Sawla General Hospital, Southern Ethiopia: A facility-based cross-sectional study

“…Our finding is lower than the results of several studies [ 13 , 14 , 28 , 29 ]. Studies conducted in Calabar, Nigeria (76.0%) [ 14 ], Southeastern Nigeria (76.3%) [ 13 ], Uganda (47.8%) [ 28 ], and China (51.9%) [ 29 ] reported higher prevalence than ours.…”

“…Our finding is lower than the results of several studies [ 13 , 14 , 28 , 29 ]. Studies conducted in Calabar, Nigeria (76.0%) [ 14 ], Southeastern Nigeria (76.3%) [ 13 ], Uganda (47.8%) [ 28 ], and China (51.9%) [ 29 ] reported higher prevalence than ours. The inclusion of many female participants in those studies done in Nigeria could be one possible reason for the disparity.…”

“…In line with our finding, having a CD 4 cells count below 200 cells/mm 3 has increased the risk of anemia by 2.15-fold (95% CI: 1.21–3.82) and 4.2-fold (95% CI: 2.03–8.67) in Wolaita Sodo [ 20 ] and Zewditu Memorial Hospital [ 22 ], respectively. Similar findings were reported from studies done in southeastern Nigeria [ 13 ] and Ethiopia [ 16 ]. The ability of HIV infection to suppress hemopoiesis might explain the observed association [ 2 , 3 ].…”

“…In a recent systematic review and meta-analysis, its pooled prevalence was 46.6% among HIVinfected adults worldwide [11]. Studies conducted in China, Nigeria, and South Africa have reported a prevalence of anemia among HIV patients ranging from 25.8% to 75% [12][13][14][15]. Ethiopia carries high burden of anemia, where 31.0% pooled prevalence is found among HIVinfected adults [16].…”

Duration of Zidovudine Consumption Correlates with Anemia in People Living with HIV

“…This study showed a significant association (p=0.001) between sex and the risk of anemia in HIV patients. This is in line with the result that women living with HIV/AIDS are more prone to anemia than men (Nnamani et al, 2021). A significant correlation (p=0.002) was also discovered between age and the incidence of anemia in patients administered AZT.…”