Incidence of anaemia among HIV‐infected patients treated with highly active antiretroviral therapy^*

Abstract

ObjectiveThe aim of the study was to compare the incidence of anaemia in patients treated with zidovudine (ZDV) with that in patients treated with highly active antiretroviral therapy (HAART) not including ZDV. MethodsUsing HIV Insight, a database of abstracted US HIV care centre medical charts, ZDV-naïve patients starting ZDV-containing HAART were compared with those starting non-ZDV, nucleoside reverse transcriptase inhibitor-containing HAART. Cohorts were divided as follows: group 1: without baseline anaemia [haemoglobin (Hb) 11 g/dL]; group 2: with baseline anaemia (Hb o11 g/dL). The incidence of anaemia (anaemia diagnosis, Hb o11 g/dL, erythropoietic therapy or blood transfusion) was computed for group 1. The anaemia hazard ratio (HR) was adjusted using Cox regression. The rate of worsening anaemia (Hb decrease 1.0 g/dL) was computed for group 2. ResultsIn group 1, the incidence of anaemia was 24.3 and 8.1 per 100 person-years in the ZDV and non-ZDV cohorts, respectively, after 6 months of follow-up, and 12.5 and 5.3 per 100 person-years after 24 months. Significant predictors of anaemia were ZDV, low initial Hb, injecting drug use, CD4 count o200 cells/mL and AIDS. The adjusted HR for ZDV was 1.6 (P 5 0.005). In group 2, the ZDV/ non-ZDV risk ratio for worsening anaemia was 2.2 (95% confidence interval 1.1-4.3). ConclusionsPatients initiating ZDV-containing HAART are at greater risk of developing new anaemia or worsening anaemia than patients initiating non-ZDV-containing HAART.

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

“…In ten patients recovery took as long as 6 months and may be due to the fact that Myelotoxic effect of AZT can persists as long as 3 months [6]. The factors having correlation with AZT induced anaemia like age, sex, wt., Hb level [9,10], CD 4 count, stage of disease [11] was present in various studies We found only significant association of low CD 4 count with increased risk of developing AZT induced anaemia (p = 0.0001). Incidence of anaemia was much lower (6.18 %) in patients initiated on stavudine based regimen and then substituted with AZT as compared to those initiated on AZT therapy (14.6 %) and may be due to improvement of wt., Hb, CD 4 count with stavudine based HAART.…”

Factors associated with zidovudine substitution in HIV/AIDS patients attending Badung Hospital, Bali, Indonesia between 2006-2014

“…This finding is also consistent with previous studies. 12,4,13 One cross-sectional study in Indonesia found that there was an early decrease in mean Hb levels after starting AZT from 12.3 to 11.4 g% thus increasing the risk of substitution AZT. 10 Another study in Cambodia also showed an association between discontinuation of AZT and initial Hb <10 g% when starting ARV.…”

Nutritional status and CD4 cell counts in patients with HIV/AIDS receiving antiretroviral therapy

“…Despite the advances achieved with HAART, studies have demonstrated a high incidence of anemia in patients submitted to this form of therapy that seems to be associated with the hematologic toxicity of antiretroviral agents, which can inhibit the formation of progenitor blood cells 29 . Berhane et al 30 reported that the use of HAART for six months is suffi cient for the development of anemia, which may become aggravated depending on the duration of the use of the drugs.…”