Risk factors and correlates for anemia in HIV treatment-naïve infected patients: a cross-sectional analytical study

Abstract

BackgroundHematologic manifestations of the human immunodeficiency virus (HIV) infection are a well-recognized complication of the disease and may be clinically important. Our objective was to determine the risk factors for anemia and its correlation with HIV treatment-naïve infected patients without co-infection or opportunistic diseases.FindingsWe performed a cross-sectional comparative study in which HIV treatment-naïve infected patients with anemia were compared with a control group of HIV patients without anemia. The interrelationship between risk factors and anemia was determined. Odds ratio and 95% confidence intervals were calculated, to adjust for the effects of potential confounders and we used a logistic regression model. Pearson's correlation coefficient was obtained to calculate the correlation between risk factors and hemoglobin.We enrolled 54 men and 9 women. Anemia was found in 13 patients; prevalence .20 (CI 95% 0.12-0.32). Severe anemia was found in only one patient (1.5%). Only CD4+ Cells Count <200 cells/mm3 was associated with increased risk of anemia in the multivariate analysis. There was a moderately strong, positive correlation between WBC and hemoglobin (r = 0.49, P < 0.001) and between CD4+ cell count and hemoglobin (r = 0.595, P < 0.001) and a moderately strong, negative correlation between HIV RNA viral load and hemoglobin (r = - 0.433, P < 0.001).ConclusionsAnemia is a common manifestation in the Mexican population without antiretroviral therapy. In HIV naïve patients a CD4+ Cell Count < 200 cells/mm3 was associated with an increased risk of anemia. There is a positive correlation between hemoglobin and CD4+ cell count.

A Study of Alternate Biomarkers in HIV Disease and Evaluating their Efficacy in Predicting T CD4+ Cell Counts and Disease Progression in Resource Poor Settings in Highly Active Antiretroviral Therapy (HAART) Era

“…Elevated CRP was a good predictor of CD4 counts of <200 cells/mm 3 , as was observed in the current study [20]. A mod erate correlation was observed in our study between anaemia and CD4 cells of <200 cells/mm 3 , as was observed in the study of Mata-Marin et al, [21]. Suresh Venkata Satya Attili et al, in a study which was done in northern India, studied the haematological profiles of 470 HIV seropositive patients and found that moderate to severe anaemia and leucopaenia were associated with CD4 cell counts of < 200 cells/mm 3 [22].…”

Prevalence of hematological abnormalities and malnutrition in HIV-infected under five children in Enugu

“…[4] This could be because the anthropometric indices used in calculating nutritional status in that [4] and the index study assess macronutrient deficiency, whereas deficiencies of micronutrients such as iron, vitamin B complex, and folic acid deficiencies are factors associated with anemia. [17] We did not find severe neutropenia or thrombocytopenia in our study, although malnourished subjects and those on HAART had comparatively low neutrophil and platelet counts. Myelosuppression consequent on HAART treatment and malnutrition could have contributed to this finding.…”

“…[9] The high CD4 cell count of our subjects may have contributed to the low prevalence of anemia, as HIV positive children with high CD4 cell count are less likely to have anemia. [7,14] Mata-Marín and others [17] in their study documented CD4 cell count below 200 cells/mm 3 (severe immunosuppression) as the only risk factor associated with anemia in their subjects. In the study by Ruhinda et al, [8] advanced disease, low CD4 cell count young age (age range of study population 3 months-18 years) were risk factors associated with anemia.…”

Challenges associated with the treatment of Buruli ulcer

“…HIV commonly presents with clinical anemia as part of a pan‐cytopenic cell line presentation . The severity of the anemia correlates with the extent of immunosuppression as expressed by declining CD4 count . Some studies have revealed association of mycobacteria infections with worsening peripheral blood cytopenia even though such has not been proven with MU infection .…”