Anaemia is an independent predictive marker for clinical prognosis in HIV-infected patients from across Europe

Mocroft, Amanda; Kirk, Ole; Barton, Staci C.; Dietrich, M.; Proença, Rui; Colebunders, Robert; Pradier, Christian; A, d'Arminio Monforte; Ledergerber, Bruno; Lundgren, Jens D.

doi:10.1097/00002030-199905280-00010

Cited by 354 publications

(371 citation statements)

References 19 publications

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“…To our knowledge hemoglobin has never shown to predict mortality of patients on ART in India, further studies are needed to confirm our findings. Baseline hemoglobin level can be used as a simple and practical tool for initial risk assessment in the absence of CD4 cell count and viral load, as was identified in earlier studies by Johannessen et al (2008) in Tanzania, Jerene et al (2006) in Ethopia and Mocroft et al (1999) in Europe.…”

Section: Discussionmentioning

confidence: 96%

Determination of Predictors Associated With HIV/AIDS Patients on ART Using Accelerated Failure Time Model for Interval Censored Survival Data

Swain¹,

Grover²

2016

American Journal of Biostatistics

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Abstract:The main objective of this paper is to identify the independent predictors affecting the survival of HIV/AIDS infected patients on Antiretroviral Therapy (ART), an interval censored event time outcome. A total of 2052 HIV/AIDS patients, who were on ART at Ram ManoharLohia Hospital, New Delhi, India, during the period of April 2004 to December 2010, were included for analysis. Accelerated Failure Time Models (AFTM) viz., exponential, Weibull, lognormal and loglogistic for interval censored survival data, have been used to determine the significant predictors for HIV/AIDS infected patients. The best model is selected on the basis of Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) values. Out of 2052 HIV/AIDS patients 65.4% were males and 34.6% were females. A majority 93.7% of patients had CD4 cell counts below 350 cells/mm 3 at the time of initiation of ART. The mean age of patients at diagnosis was 34.28±8.19 years. The prognostic factorsviz., age, sex, CD4 cell count, past smokers, baseline hemoglobin and baseline BMI are found to be statistically significant (p<0.000) for HIV/AIDS patients on ART. Hence, a special attention is needed for patients with low CD4 cell counts, low BMI and low hemoglobin. Lognormal AFT model is found to be the best model to identify the independent predictors for survival of HIV population.

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Section: Discussionmentioning

confidence: 96%

Determination of Predictors Associated With HIV/AIDS Patients on ART Using Accelerated Failure Time Model for Interval Censored Survival Data

Swain¹,

Grover²

2016

American Journal of Biostatistics

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“…The prevalence and incidence of anemia varies in different socioeconomic conditions and clinical settings. In Europe and North America, anemia was found in 35-65% of HIV-infected patients pre-cART (21,22). Prevalence rates of 42.9% (3) and 18.9% (1) were reported in Ethiopia and in a rural Ugandan cohort, respectively.…”

Section: Discussionmentioning

confidence: 99%

Anemia in combined antiretroviral treatment-naive HIV-infected patients in China: A retrospective study of prevalence, risk factors, and mortality

Dai

Xiao

Gao

et al. 2016

BST

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“…2,5,6 Mocroft and others found that severe anemia was associated with a much faster rate of HIV disease progression and confirmed that anemia is a strong independent predictor of death. 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.…”

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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Anaemia is an independent predictive marker for clinical prognosis in HIV-infected patients from across Europe

Abstract: Severe anaemia occurred infrequently among these patients but was associated with a much faster rate of disease progression. Among patients with similar CD4 lymphocyte counts and viral load, the latest value of haemoglobin was a strong independent prognostic marker for death.

Cited by 354 publications

References 19 publications

Determination of Predictors Associated With HIV/AIDS Patients on ART Using Accelerated Failure Time Model for Interval Censored Survival Data

Determination of Predictors Associated With HIV/AIDS Patients on ART Using Accelerated Failure Time Model for Interval Censored Survival Data

Anemia in combined antiretroviral treatment-naive HIV-infected patients in China: A retrospective study of prevalence, risk factors, and mortality

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

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