Treatment for anemia in people with AIDS

Martí‐Carvajal, Arturo J; Solà, Iván; Peña‐Martí, Guiomar E; Comunián‐Carrasco, Gabriella

doi:10.1002/14651858.cd004776.pub3

Cited by 15 publications

(12 citation statements)

References 143 publications

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“…Anaemia is recognized as the most common haematological complication of Human Immunodeficiency Virus (HIV) infection worldwide [1,2] The World Health Organization (WHO) defines anaemia as a haemoglobin level below 110-120 g/l. In sub-Saharan Africa, 60% of HIV-infected adults are anaemic and 22% are severely anaemic [3,4].…”

Section: Introductionmentioning

confidence: 99%

Severe anaemia complicating HIV in Malawi; Multiple co-existing aetiologies are associated with high mortality

et al. 2020

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Background Severe anaemia is a major cause of morbidity and mortality in HIV-infected adults living in resource-limited countries. Comprehensive data on the aetiology are lacking but are needed to improve outcomes. Methods HIV-infected adults with severe (haemoglobin �70g/l) or very severe anaemia (haemoglobin � 50 g/l) were recruited at Queen Elizabeth Central Hospital, Blantyre, Malawi. Fifteen potential causes and associations with anaemia severity and mortality were explored. Results 199 patients were enrolled: 42.2% had very severe anaemia and 45.7% were on ART. More than two potential causes for anaemia were present in 94% of the patients including iron deficiency (55.3%), underweight (BMI<20: 49.7%), TB infection (41.2%) and unsuppressed HIV infection (viral load >1000 copies/ml) (73.9%). EBV/CMV co-infection (16.5%) was associated with very severe anaemia (OR 2.8 95% CI 1.1-6.9). Overall mortality was high (53%; 100/199) with a median time to death of 17.5 days (IQR 6-55) days. Death was associated with folate deficiency (HR 2.2; 95% CI 1.2-3.8) and end stage renal disease (HR 3.2; 95% CI 1.6-6.2).

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Section: Introductionmentioning

confidence: 99%

Severe anaemia complicating HIV in Malawi; Multiple co-existing aetiologies are associated with high mortality

et al. 2020

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“…HIV may cause anaemia by its direct effect on BM cells, but can also affect other aetiological factors including opportunistic viral, bacterial and parasitic infections, drugs such as zidovudine and co-trimoxazole, micronutrient deficiencies and neoplastic diseases [5,6]. The exact role of iron deficiency, as one of the few preventable and treatable causes of anaemia, remains unclear due to its diagnostic challenges in HIV-infected patients in low resource settings [3,4,7]. However iron supplementation has been shown to be a risk factor for infections in areas of high infectious burden [8,9].…”

Section: Introductionmentioning

confidence: 99%

A possible role for hepcidin in the detection of iron deficiency in severely anaemic HIV-infected patients in Malawi

et al. 2020

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Introduction Iron deficiency is a treatable cause of severe anaemia in low-and-middle-income-countries (LMIC). Diagnosing it remains challenging as peripheral blood markers poorly reflect bonemarrow iron deficiency (BM-ID), especially in the context of HIV-infection. Methods Severely anaemic (haemoglobin �70g/l) HIV-infected adults were recruited at Queen Elizabeth Central Hospital, Blantyre, Malawi. BM-ID was evaluated. Accuracy of blood markers (including hepcidin, mean corpuscular volume, mean cellular haemoglobin concentration, serum iron, serum ferritin, soluble transferrin receptor (sTfR), sTfR index, sTfR-ratio) to detect BM-ID was evaluated by ROC area under the curve (AUC ROC). Results Seventy-three patients were enrolled and 35 (48.0%) had BM-ID. Although hepcidin and MCV performed best (AUC ROC of 0.593 and 0.545 respectively) all markers performed poorly in identifying BM-ID (ROC<0.6). The AUC ROC of hepcidin in males was 0.767 (sensitivity 80%, specificity 78%) and in women 0.490 (sensitivity 60%, specificity 61%). Conclusion BM-ID deficiency was common in severely anaemic HIV-infected patients. It is an important and potential treatable contributor to severe anaemia but lack of definitive biomarkers

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“…Among patients on ART those on AZT containing regimen had higher prevalence of anaemia which is similar to observation from previous studies. 7,16…”

Section: Association Between Anaemia and Type Of Art Regimen Among Himentioning

confidence: 99%

A Study of Prevalence of Anemia among HIV Patients and its Correlation with Clinical Stage of Aids, Cd4 Count and Antiretroviral Therapy

Zunke¹,

Waran²,

Tyagi³

2017

IJMSCI

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Anaemia is an important clinical problem in patients with HIV infection and those with AIDS. The causes of anaemia in HIV infection are multifactorial. HIV per se causes decrease in production of RBCs and other bone marrow elements, as it has direct effect on bone marrow stromal cells and cause cytokine secretion. The elevated level of cytokines and Tumour necrosis factor further inhibit haematopoiesis in HIV. There is also evidence of increased risk of anaemia in association with zidovudine use, CD4 cell counts of <200 cells/μl and high viral load. This study was conducted to find out the incidence of anaemia among patients with HIV and its association with WHO clinical staging, CD4 count and Anti-Retroviral Therapy (ART). The study was conducted at department of medicine of a tertiary care teaching hospital in western Maharashtra from July 2015 to September 2016. A total of 316 patients (106 Outpatients and 214 indoor patients) were included in the study. Significantly high prevalence of anaemia was seen in patients in WHO stage II-IV, with the highest prevalence in stage III. Although anaemia was seen in all levels of CD4 counts, anaemia prevalence 89.5% was significantly high in patients with CD4 count < 200 cells/μl. The patients not on ART had higher prevalence of anemia than those who were receiving ART, regardless of whether the regimen was AZT containing or not. The study highlights that advanced disease, low CD+ count and non-exposure to ART are adverse risk factors for development of anemia among HIV patients.

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Treatment for anemia in people with AIDS

Cited by 15 publications

References 143 publications

Severe anaemia complicating HIV in Malawi; Multiple co-existing aetiologies are associated with high mortality

Severe anaemia complicating HIV in Malawi; Multiple co-existing aetiologies are associated with high mortality

A possible role for hepcidin in the detection of iron deficiency in severely anaemic HIV-infected patients in Malawi

A Study of Prevalence of Anemia among HIV Patients and its Correlation with Clinical Stage of Aids, Cd4 Count and Antiretroviral Therapy

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