Anaemia in Pregnancy Is Associated with Advanced HIV Disease

Abstract

BackgroundAnaemia is a common clinical finding in HIV infected women and has been associated with advanced disease. The use of antiretroviral drugs such as Zidovudine (ZDV) either for prevention of mother to child transmission (MTCT) of HIV or used in combination with other antiretrovirals have been implicated in the development or increased severity of anaemia. We report the prevalence, type, severity and incidence of anaemia in a cohort of HIV infected women who initiated antiretroviral prophylaxis or treatment during pregnancy.Methods and MaterialsThis is a retrospective cohort data analysis of 408 HIV infected pregnant women who participated in a breastfeeding intervention study (HPTN 046 Study, ClinicalTrials.gov NCT 00074412) in South Africa. Women initiated zidovudine prophylaxis for PMTCT or triple antiretroviral treatment in pregnancy according to the standard of care. Laboratory and clinical data in pregnancy, <72 hours and 2 weeks postdelivery were extracted from the main database and analysed.ResultsThe mean Hb concentration was 10.6 g/dL at baseline and 262/408 (64.2%) women were diagnosed with anaemia (Hb<11 g/dL) in pregnancy, 48/146 (32.9%) subsequently developed anaemia intrapartum or postpartum and 89/310 (28.7%) of all cases of anaemia remained unresolved by 2 weeks postdelivery. In a univariate analysis, CD4 count and gravidity were significant risk factors for anaemia in pregnancy, RR 1.41; 1.23–1.61 (p<0.001) and 1.10; 1.01–1.18 (p = 0.02) respectively. After adjusting for antiretroviral regimen, age and gravidity in a multivariable analysis, only the CD4 count remains a significant risk factor for anaemia in pregnancy and postdelivery.ConclusionIn conclusion, anaemia was most common among women in the advanced stage of HIV infection (CD4<200 cells/mm3). There was no evidence of an association between ZDV or triple ARVs and anaemia.

Prevalence of anaemia in pregnancy in a regional health facility in South Africa

“…HIV infection has been reported to be associated with anaemia, either independently or due to antiretroviral medica t ions such as zidovudine. A recent report by Nandlal et al [14] states that anae mia is a common finding in HIV-infected pregnant women. In our study, a high prevalence of anaemia (71.3%) was observed in HIV-infected patients, 2.5 times higher than in those who were uninfected (Table 3).…”

Association Between Anaemia And Low Birth Weight Among HIV -Infected Pregnant Women Aged 15 – 49 Years In Zimbabwe : A Cross-Sectional Study

“…It was found that female infants had a higher risk of LBW as opposed to male infants and that as parity increased, the risk of LBW decreased.The prevalence of anaemia in this cross-sectional study was 42.3% amongst HIV infected women, while the prevalence of LBW among anaemic women was 14.6%. Other studies have reported prevalence of maternal anaemia amongst HIV positive women in developing countries ranging between 14-62%[10,16,4]. The overall LBW prevalence in Zimbabwe in this study population of HIV positive infected women in 2015 was 16.3%.…”

Association of HIV and highly active antiretroviral therapy with clinical and biochemical indices among women with pre‐eclampsia

“…In the present study, there was no difference in the hemoglobin level between the two groups (108.0 vs 109.0 g/L, P = 0.56). An association of anemia in pregnancy with lower CD4 counts among women with HIV infection taking antiretroviral therapy has been recently reported [22].…”