The Impact of Anemia on Energy and Physical Functioning in Individuals With AIDS

Semba, Richard D.; Martin, Barbara K.; Kempen, John H.; Thorne, Jennifer E.; Wu, Albert W.

doi:10.1001/archinte.165.19.2229

Cited by 44 publications

(30 citation statements)

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“…7 Uncorrected anemia results in multisystemic disabling symptoms and fatigue, exhaustion, increased risk of HIV dementia, poor quality of life and possibly even exacerbates poverty in communities with a high HIV prevalence. [8][9][10][11] Conversely, survival time in HIV-infected persons may be improved after recovery from anemia. 2,10 The pathogenesis of anemia in HIV-infected persons is complex.…”

Section: Introductionmentioning

confidence: 99%

Anemia in Human Immunodeficiency Virus–Infected and Uninfected Women in Rwanda

Masaisa¹,

Gahutu²,

Mukiibi³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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Abstract. To determine the prevalence and risk factors of anemia among human immunodeficiency virus (HIV)-infected women in Rwanda and the influence of highly active antiretroviral therapy (HAART) on anemia, we analyzed 200 HIV-positive women and 50 HIV-negative women in a cross-sectional study. Clinical examinations and iron and vitamin B 12 assays were performed, and complete blood counts, serum folic acid levels, and CD4 cell count determined. The prevalence of anemia was significantly higher among HIV-positive women (29%) than among HIV-negative women (8%) ( P < 0.001). Risk factors for anemia were lower body mass index (odds ratio [OR] = 3.4, 95% confidence interval [CI] = 2.4-4.1), zidovudine use (OR = 1.14, 95% CI = 1.01-1.29), lack of HAART (OR = 1.44, 95% CI = 1.21-1.67), oral candidiasis (OR = 1.4, 95% CI = 1.2-1.6), pulmonary tuberculosis (OR = 1.8, 95% CI = 1.7-2.2), cryptococcal meningitis (OR = 1.6, 95% CI = 1.21-1.8), Pneumocystis jiroveci pneumonia (OR = 1.41, 95% CI = 1.20-1.65) and CD4 lymphocyte count < 200 cells/µL (OR = 2.41, 95% CI = 2.01-3.07). The mean ± SD hemoglobin level of 10.9 ± 1.6 g/dL at HAART initiation significantly increased to 12.3 ± 1.5 g/dL in 8 months ( P < 0.001). Anemia increases with HIV stage, and HAART is associated with a significant improvement in hemoglobin levels.*Address correspondence to Jean Bosco Gahutu, Faculty of Medicine, National University of Rwanda, PO Box 30, Huye, Rwanda. E-mail: jgahutu@nur.ac.rw 457 ANEMIA IN HIV-INFECTED AND UNINFECTED WOMEN, RWANDA level < 11.5 mg/dL by using reference ranges based upon local control measurements in our laboratory, which is located at a moderate altitude of 1,768 meters. This limit was also shown by Beutler and Waalen. 20 Serum iron, vitamin B 12 , and folic acid levels were measured in the clinical laboratory of Ghent University Hospital. However, erythropoietin assays and the screening for malaria and chronic helminthes were not systematically conducted.The first-line HAART regimen at the time of the study consisted of stavudine or zidovudine, plus lamivudine, plus nevirapine or efavirenz; more patients used stavudine and nevirapine than zidovudine and efavirenz. For all the patients who initiated HAART at the time of entry into the study, they were all given a stavudine-based regimen. No patients were taking other antiretroviral medications such as tenofovir, abacavir, or protease inhibitors. Women receiving zidovudine for prevention of mother-to-child transmission of HIV were not included in the study population.Most patients were given cotrimoxazole prophylaxis with a dose of 1 tablet of 960 mg daily when CD4 cell counts were less than 350 cells/μL when possible. However, because many patients initially only sought care when they have reached advanced stages of immunosuppression, some patients were given prophylaxis at lower CD4 cell counts. No persons were offered ferrous sulfate and/or multivitamins for the treatment of anemia.Statistical analysis. All statistical analyses were performed with SPSS software ...

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Section: Introductionmentioning

confidence: 99%

Anemia in Human Immunodeficiency Virus–Infected and Uninfected Women in Rwanda

Masaisa¹,

Gahutu²,

Mukiibi³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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“…A infecção pelo HIV, além do comprometimento imunológico, está associada a uma grande variedade de anormalidades hematológicas, como: hematopoese alterada, citopenias imunomediadas e coagulopatias 3,4 , sendo a anemia a alteração hematológica mais frequente [4][5][6][7][8][9] . Estudo epidemiológico recente tem relatado que a prevalência de anemia em pacientes soropositivos tem sido estimada entre 63% a 95% 10 .…”

Section: Segundo O Relatório Epidemiológico Do Joint United Nations Punclassified

“…Estudo epidemiológico recente tem relatado que a prevalência de anemia em pacientes soropositivos tem sido estimada entre 63% a 95% 10 . As consequências da anemia incluem capacidade de trabalho reduzida 11 , diminuição da sensação de bem-estar e aumento da necessidade de hospitalizações 9 . Além disso, em vários estudos a anemia foi relacionada à redução da qualidade de vida e ao menor tempo de sobrevivência em HIV-positivo 4,6,[12][13][14] .…”

Section: Segundo O Relatório Epidemiológico Do Joint United Nations Punclassified

“…Além disso, em vários estudos a anemia foi relacionada à redução da qualidade de vida e ao menor tempo de sobrevivência em HIV-positivo 4,6,[12][13][14] . Pesquisas mostram que intervenções para prevenir a anemia podem levar à melhora da saúde, da qualidade e da expectativa de vida em infectados pelo HIV 6,9,12,15,16 . Segundo Moyle, a correção da anemia reduz o risco de progressão da doença para níveis semelhantes aos dos que nunca apresentaram a mesma 16 .…”

Section: Segundo O Relatório Epidemiológico Do Joint United Nations Punclassified

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Anemia em Pacientes HIV-Positivo Atendidos em um Hospital Universitário de Pernambuco – Nordeste do Brasil

Feitosa¹

2011

J bras doenças sex transm

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RESUMOIntrodução: a anemia é a complicação hematológica mais frequente em pacientes infectados pelo HIV. Objetivo: avaliar a frequência de anemia em pacientes com vírus da imunodeficiência humana atendidos no Hospital das Clínicas de Pernambuco, durante o período de março a outubro de 2010. Métodos: estudo do tipo série de casos, composto por 108 indivíduos de ambos os sexos na faixa etária de 20 a 59 anos, no qual foi avaliada a frequência de anemia e sua associação com algumas características socioeconômicas, demográficas, clínicas e antropométricas. Resultados: foi evidenciado um predomínio do sexo masculino (60,2%) com média de idade próxima aos 40 anos e precário nível socioeconômico (74,2% dos pacientes com renda familiar inferior a dois salários mínimos). A frequência de anemia foi elevada, em 56,4% da amostra, sendo na sua maioria classificada como normocítica (59,0% dos anêmicos) e de gravidade moderada (49,2%). Na avaliação antropométrica, 18,5% e 27,7% dos pacientes foram classificados como baixo peso e excesso de peso, respectivamente, e um elevado percentual teve diagnóstico de desnutrição pela avaliação das medidas do braço (circunferência do braço (CB) = 64,8%; prega cutânea tricipital (PCT) = 72,3%; e circunferência muscular do braço (CMB) = 49,1%). Na análise da associação entre a anemia e as variáveis estudadas, foi evidenciada associação com a renda familiar ≤ 2 salários mínimos, com o nível de células CD4 < 200 céls./mm 3 e com a ocorrência de infecções oportunistas. Conclusão: a elevada prevalência de anemia na amostra estudada representa um alerta, considerando que esse distúrbio tem sido associado à piora da condição clínica e ao risco aumentado de mortes em pacientes infectados pelo HIV. Palavras-chave: síndrome da imunodeficiência adquirida, anemia, avaliação nutricional, antropometria, HIV, DST ABSTRACT Introduction: anemia is the most frequent hematological complication in HIV-infected patients. Objective: to evaluate the frequency of anemia in patients with human immunodeficiency virus treated at Hospital das Clínicas de Pernambuco, during the period from March to October 2010. Methods: the study of case series consisting of 108 individuals of both sexes aged 19 to 59 years old in which the frequency of anemia and its association with some socioeconomic, demographic and clinical variables were rated. Results: a male predominance (60.2%) with an average age close to 40 years and precarious economic level (74.2% of patients with family income below two minimum wages) was observed. The frequency of anemia was high, 56.4% of the sample being mostly classified as normocytic (59.0% of anemic) and of moderate severity (49.2%). Anthropometric evaluation, 18.5% and 27.7% of patients were classified as underweight and overweight, respectively, and a high percentage of malnutrition was diagnosed by assessing the actions of the arm (Midarm Circumference (MC) = 64, 8%; Triceps Skinfold Thickness (TSF) = 72.3% and Mid-arm Muscle Circunference (MMC) = 49.1%). To examine the association between anemi...

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“…Guimarães (2009) Variáveis clínicas, como baixa carga viral e taxas maiores de células CD4, mostraram ser importantes indicadores clínicos/imunológicos da melhor QV (CÔTÉ et al, 2009;SEMBA et al, 2005). O uso de ARV, estágio clínico da infecção e a presença de comorbidades também têm sido estudados pelos pesquisadores (JIA et al, 2007).…”

Section: Referencial Teórico 39unclassified

Qualidade de vida de indivíduos com a coinfecção HIV/tuberculose no município de Ribeirão Preto - SP

Neves¹

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Qualidade de vida de indivíduos com a coinfecção HIV/tuberculose no município de Ribeirão Preto -SPand recent use of anti-retroviral therapy, different from serum-positive patients which presented better clinics indexes and use of ARV for a longer time. The most common clinic form of TB was the lung one, but with high levels of extra lung ones. In the assessment of quality of life, co-infected people showed lower average scores than those non-co-infected in all levels, with important difference in Physical, Psychological, Level of Independence and Social Relations. The values of social support were intermediate, but with wide range of scores; there was some association between social support and nearly all levels of quality of life, with exception of spirituality. Conclusions: The large number of co-infected patients with low socio-economic level stressed the narrow relation of double infection with social exclusion, showing TB and HIV/AIDS as diseases with a magnitude that transcends biological barriers. Quality of life of people carrying HIV/TB co-infection was worse than those serum-positive without TB in all levels. Social support has an important role in soothing negative consequences of stressing events, and it may minimize the effect of prejudice on both diseases and influencing in a direct way the quality of life of a co-infected person. Introducción: La tuberculosis (TB) es la infección oportunista más común asociada con el VIH / SIDA, su asociación con el VIH afecta la vida de una persona de una manera negativa, tanto en los aspectos psicosociales y biológicos. La debilidad física, relacionada con el estigma y la discriminación contra las dos enfermedades pueden conducir al aislamiento social y la restricción de las relaciones, perjudicando el mantenimiento de la red de apoyo social y calidad de vida de las personas con coinfección TB / VIH. Objetivo: Evaluar la calidad de vida de las personas con coinfección VIH / tuberculosis y comparar la calidad de vida de las personas seropositivas para el VIH. Materiales y Métodos: Se realizó un estudio descriptivo, con el corte transversal, realizado mediante entrevistas con seropositivos para el VIH y com coinfectados VIH / TB sometidos a seguimiento ambulatorio en Ribeirão Preto; se utilizó el WHOQOL bref VIH, Inventario de Apoyo Social para Personas que Viven con el VIH / SIDA y instrumento de las características socioeconómicas. Resultados: participaron 115 personas VIH positivas, 57 de ellos coinfectados con tuberculosis y 58 no-coinfectado. La mayoría eran hombres, heterosexuales, sobre todo en sus 40's años, con los coinfectados presentan educativos y los ingresos inferiores a que otros. Alrededor de un tercio de los afectados por la TB activa recientemente se enteró de su condición de VIH, la mayoría de las cifras presentadas por los linfocitos T CD4 por debajo de 200 células/mm3 y el uso reciente de la terapia antirretroviral, a diferencia de los pacientes VIH-positivos que tenían mejores índices de clínicas y el uso de antirretrovirales durante un tiem...

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The Impact of Anemia on Energy and Physical Functioning in Individuals With AIDS

Abstract: Higher levels of hemoglobin are associated with better quality of life among individuals with AIDS. Changes in hemoglobin level within the conventional normal range of hemoglobin are also significantly associated with changes in quality of life.

Cited by 44 publications

References 25 publications

Anemia in Human Immunodeficiency Virus–Infected and Uninfected Women in Rwanda

Anemia in Human Immunodeficiency Virus–Infected and Uninfected Women in Rwanda

Anemia em Pacientes HIV-Positivo Atendidos em um Hospital Universitário de Pernambuco – Nordeste do Brasil

Qualidade de vida de indivíduos com a coinfecção HIV/tuberculose no município de Ribeirão Preto - SP

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