Time to Development of Anemia and Predictors among HIV-Infected Patients Initiating ART at Felege Hiwot Referral Hospital, Northwest Ethiopia: A Retrospective Follow-Up Study

Abstract

Introduction. Anemia is the most common hematological abnormality in Human Immunodeficiency Virus (HIV) clients, and it is a widespread public health problem. In Ethiopia, there is limited information about time to development of anemia and predictors for anemic HIV patients. Hence, this study is aimed at determining time to development of anemia and predictors among HIV/AIDS clients taking antiretroviral therapy (ART) at Felege Hiwot Referral Hospital in Bahir Dar, northwest Ethiopia. Methods. A retrospective follow-up study was conducted among clients on ART from 2012 to 2017. Data were collected using checklists. The Kaplan-Meier curve was employed to compare survival rates. The Cox proportional hazard model was applied to identify predictors of time to development of anemia. Results. A total of 490 ART patients were followed. The overall incidence of anemia was 27/100 person-years. The incidence was highest in the second year (18.7/100 PY) of starting ART when compared with the first year (13.8/100 PY) and third year (18.1/100 PY) of ART initiation. The independent predictors show an association for time to development of anemia and were as follows: being female (AHR=2.94, 95%CI=2.15–4.0), pulmonary tuberculosis positive (AHR=2.98, 95%CI=1.62–5.51), baseline weight<60 kg (AHR=1.51, 95%CI=1.19-1.92), and severe acute malnutrition (AHR=2.0, 95%CI=1.39-2.89). Conclusion. Most of the anemia cases occurred after the first year of ART initiation. Pulmonary tuberculosis, baseline weight, nutritional status, and sex were predictors for anemia. Clients with low baseline weight and abnormal nutritional status need to get close follow-up to prevent the risk of early development of anemia.

Predictors of Anemia Among Adult HIV Positive Patients on First-Line Antiretroviral Therapy in Northwest Ethiopia: A Retrospective Follow-Up Study

“…This finding was comparable with the figure generated from similar studies done in South India, 25 Uganda, 26 and at Bahir Dar, Ethiopia. 27 The agreement of our study finding with others such as the study in Bahir Dar might have been due to the similarity of population characteristics as the two studies were conducted in the same region, similar study setting where both were conducted in tertiary hospitals, and relatively similar duration of the studies, and similar definition for anemia used in both studies. However, the incidence of anemia in our study was lower compared to studies conducted in Nigeria 28 and Addis Ababa.…”

Incidence and predictors of anemia among adults on HIV care at South Gondar Zone Public General Hospital Northwest Ethiopia, 2020; retrospective cohort study

“…Almost one fifth (21.6%) of the study participants develop anemia giving an incidence density rate of 6.27(95% CI: 0.051, 0.077) per 100 person-years of observation. The overall incidence rate was lower than the study conducted in Northwest Ethiopia which was 27/100 PYO [ 41 ] and in the Capital city of Ethiopia which was 35.3/100 PYO [ 42 ]. This noticeable discrepancy might be related to early initiation of ART for participants in the current study irrespective of CD4 count and WHO clinical staging [ 35 ] and availability of new drug regimen (dolutegravir containing regimen).…”

“…The sample size was determined by a two-sample comparison of survival functions Log-rank test via Stata version 14.0 using 5% significant level, 80% power and one to one non exposed to exposed ratio, and considering significant predictors of developing anemia in the previous study in Ethiopia [ 41 ]. The final sample size was 434.…”

Diagnóstico de enfermagem risco de infecção e infecções relacionadas à assistência à saúde em pacientes com aids

“…Marques CC, Barreto VP, Silva BC, Santos MM, Medeiros ER, Guedes GS, et al A ocorrência de anemia tem causa multifatorial, incluindo a presença de infecções oportunistas, deficiências nutricionais, efeito supressivo do HIV em fatores hematológicos e efeitos tóxicos de drogas antirretrovirais. (33) No presente estudo, a redução no nível de hemoglobina pode estar relacionada à presença precoce de infecções oportunistas quando da admissão no hospital, ao quadro clínico desfavorável avançado e ao regime de TARV baseado em zidovudina. Um estudo (33) mostrou que esse medicamento inibe a atividade da medula óssea, reduzindo a produção de células sanguíneas e elevando o risco de anemia.…”

“…(33) No presente estudo, a redução no nível de hemoglobina pode estar relacionada à presença precoce de infecções oportunistas quando da admissão no hospital, ao quadro clínico desfavorável avançado e ao regime de TARV baseado em zidovudina. Um estudo (33) mostrou que esse medicamento inibe a atividade da medula óssea, reduzindo a produção de células sanguíneas e elevando o risco de anemia.…”