High Incidence of Zidovudine Induced Anaemia in HIV Infected Patients in Southern Odisha

Dash, Kaibalya Ranjan; Meher, Lalit Kumar; Hui, Pankaj Kumar; Behera, Samir Kumar; Nayak, Sachidananda

doi:10.1007/s12288-014-0426-9

Cited by 13 publications

(13 citation statements)

References 9 publications

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“…In patients taking ZDV containing regimen anemia was independently predicted by the; advanced AIDS stage at baseline, advanced baseline immune suppression, cotrimoxazole prophylaxis (CPT) intake, poor adherence status, and undernutrition at baseline. This finding is in agreement with the study conducted in Thailand, 27 which reported, anemia was independently predicted by low baseline CD4 count, low BMI, and advanced AIDS stage at enrolment. The possible explanation for this association may be that HIV patients with low CD4 count are known to be at risk of multiple opportunistic infections, which are known to cause anemia.…”

Section: Discussionsupporting

confidence: 93%

Anemia in HIV/AIDS Patients on Antiretroviral Treatment at Ayder Specialized Hospital, Mekele, Ethiopia: A Case-Control Study

Berhane¹,

Haile²,

Tolessa³

2020

JBM

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Background: Human immunodeficiency virus and anemia are the major public health problems in Sub-Sahara Africa. Untreated anemia is associated with rapid progression and poor prognosis of the disease in HIV. This study was aimed at determining the magnitude, severity and associated factors of anemia among HIV infected patients taking zidovudine and tenofovir-containing first-line HAART in Ayder Comprehensive Specialized Hospital, Mekele, Ethiopia. Methods: A case-control study was conducted from February to August 2019 using both convenient and quota sampling methods. Anemia is defined as hemoglobin value below 13 g/ dl for male and below 12 g/dl for female. Sociodemographic and clinical characteristics were assessed using a structured questionnaire, medical records, electronic weighing scale, adult height board, automated hematology analyzer (Sysmex XT-4000i), and Becton Dickinson's FACS caliber flow cytometer. Descriptive statistics, tables, graphs, Student's t-test and l logistic regression were used to analyze the data. Results: About one-third (33.5%) of study participants were found to be anemic (ZDV: 20.3%; TDF: 13.2%, and p<0.05). Among these anemic cases, the majority was found to have mild, and the remaining was moderate types. The most common form was normocytic-normochromic anemia (46.5%). Cotrimoxazole prophylaxis, poor adherence, advanced AIDS stage at baseline and underweight at baseline were the factors associated with anemia in patients taking zidovudine-containing regimen (p<0.05). Advanced stage at baseline, cotrimoxazole prophylaxis, poor adherence status and lack of regular income were significantly associated with anemia in patients taking tenofovir-containing regimen (p<0.05). Conclusion: We find that the prevalence of anemia was significantly higher among patients taking ZDV-containing regimen. But different risk factors for anemia had been identified among ZDV-containing regimen, showing that appropriate follow-up, nutritional supplementation, continuous evaluation of patients on cotrimoxazole intake can reduce the risks of anemia in both types of regimens.

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Section: Discussionsupporting

confidence: 93%

Anemia in HIV/AIDS Patients on Antiretroviral Treatment at Ayder Specialized Hospital, Mekele, Ethiopia: A Case-Control Study

Berhane¹,

Haile²,

Tolessa³

2020

JBM

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“…Anaemia occurred (haemoglobin < 7 g/dl) within the first few months of initiation of therapy. In majority of the patients, improvement in haemoglobin level was observed once zidovudine containing regimen was withdrawn which was similar to the study conducted by (Kaibalya, et al 2015). So, the red blood cell disorders could have been minimized by regular monitoring of blood parameters.…”

Section: Resultssupporting

confidence: 74%

Assessment of adverse drug reactions to antiretroviral agents among HIV patients

2018

J App Pharm Sci

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Objective: The objective of the study was to determine the causality, predictability, preventability and severity of Adverse Drug Reactions (ADRs) among Human Immunodeficiency Virus (HIV) positive patients who are on Highly Active Antiretroviral Therapy (HAART). Method: All spontaneous ADRs to Anti Retroviral Agents were collected over a period of three years (July 2012-June 2015) from two Anti Retroviral Therapy (ART) centers in Mysore city, Karnataka. Predictability was assessed based on previous history on exposure to the drug or literature incidence of ADRs, preventability was assessed by using modified Schumock and Thornton scale, causality was assessed by WHO probability scale and severity was assessed by using modified Hartwig and Siegel Scale. Results: A total of 1120 ADRs were documented in the study period. Majority (94.5%) of reactions were predictable. However, 72.5% of reactions were preventable (29.5% definitely preventable, 43% probably preventable). Among all the reactions, only 34.8% was assessed to be mild and 6.4% of reactions were severe. On causality assessment 74.5% of ADRs were found to be probable in nature. Conclusion: Majority of the ADRs in HIV patients are predictable and many of these reactions may also be preventable. Even though, we may not be able to prevent all predictable ADRs, the goal should be to increase awareness on ADRs and encourage early detection and intervention by conducting similar studies in understanding the ADRs and to minimize patient discomfort which results in medication non-adherence.

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“…8 This could be explained by the fact that Zidovudine is related to suppressions of bone marrow that leads to a reduction in the production of red blood cells and other types of blood cells in the bone marrow. 26 Another significant predictor of anemia among children with ART was under-nutrition which had 2.7 times at higher risk to develop anemia than normal nutritional status. The finding was in line with a study conducted in West Africa.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Incidence and Predictors of Anemia Among Children on Antiretroviral Therapy at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2007–2017: A Retrospective Follow-Up Study

Techane¹,

Anlay²,

Tesfaye³

et al. 2020

HIV

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Background Anemia is the most common hematological abnormality among children on antiretroviral therapy. In Ethiopia, as far as our search, there are no studies done on the incidence and predictors of anemia among children on antiretroviral therapy. This study aimed to assess the incidence and predictors of anemia among children on antiretroviral therapy, attending antiretroviral therapy care at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, from 2007 to 2017. Methods A retrospective follow-up study was conducted among 391 children on antiretroviral therapy. Mean survival time for children to be anemia free was estimated. A Log rank test was used to compare survival curves among different independent variables. The Cox regression model was used. The adjusted hazard ratio (AHR) with a 95% confidence interval (CI) was calculated. P-value ≤0.05 was considered as statically significant. Results The overall incidence rate of anemia was 10.5 (95% confidence interval (8.6, 12.8)) per 100 child-year. Being severe-immunosuppressed (AHR=2.9, 95% CI: 1.23–6.77), undernutrition (AHR =2.7, 95% CI: 1.5–5), taking zidovudine-based ART regimen (AHR =4, 95% CI: 1.23–12.9), and tuberculosis (AHR =2.1, 95% CI: 1.4–3.3) were independent predictors of anemia among children. Conclusion In this study, the incidence rate of anemia among children on antiretroviral therapy was found to be high. Tuberculosis, zidovudine-based drugs, severe immunosuppression, and undernutrition have remained statically significant predictors of anemia among children on antiretroviral therapy. Children with HIV were the most vulnerable group for anemia, especially in developing countries. Therefore, improving their nutritional status and considering other predictors of anemia were very important for children to reduce the incidence of anemia among children with HIV.

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High Incidence of Zidovudine Induced Anaemia in HIV Infected Patients in Southern Odisha

Cited by 13 publications

References 9 publications

<p>Anemia in HIV/AIDS Patients on Antiretroviral Treatment at Ayder Specialized Hospital, Mekele, Ethiopia: A Case-Control Study</p>

<p>Anemia in HIV/AIDS Patients on Antiretroviral Treatment at Ayder Specialized Hospital, Mekele, Ethiopia: A Case-Control Study</p>

Assessment of adverse drug reactions to antiretroviral agents among HIV patients

<p>Incidence and Predictors of Anemia Among Children on Antiretroviral Therapy at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2007–2017: A Retrospective Follow-Up Study</p>

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