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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Antiretroviral treatment reverses HIV-associated anemia in rural Tanzania
BMC Infectious Diseases, Volume 11, Article 190, Year 2011
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Description
Background: HIV-associated anemia is common and associated with poor prognosis. However, its response to antiretroviral treatment (ART) in rural Africa is poorly understood.Methods: HIV-infected adults (≥15 years) who enrolled in HIV care at Haydom Lutheran Hospital in northern Tanzania were included in the study. The effect of ART (zidovudine/stavudine + lamivudine + efavirenz/nevirapine) on HIV-associated anemia was studied in a subset of patients who were anemic at the time they started ART and had a follow-up hemoglobin measurement 12 months later. Pregnant women were excluded from the study, as were women who had given birth within the past 6 weeks. Anemia was defined as hemoglobin <12 g/dL in women and <13 g/dL in men. We applied paired sample T-tests to compare hemoglobin levels before and one year after ART initiation, and logistic regression models to identify predictors of persistent anemia.Results: At enrollment, mean hemoglobin was 10.3 g/dL, and 649 of 838 patients (77.4%) were anemic. Of the anemic patients, 254 (39.1%) had microcytosis and hypochromia. Among 102 patients who were anemic at ART initiation and had a follow-up hemoglobin measurement after 12 months, the mean hemoglobin increased by 2.5 g/dL (P < 0.001); however, 39 patients (38.2%) were still anemic after 12 months of ART. Independent predictors of persistent anemia were mean cell volume in the lower quartile (<76.0 fL; Odds Ratio [OR] 4.34; 95% confidence interval [CI] 1.22-15.5) and a zidovudine-containing initial regimen (OR 2.91; 95% CI 1.03-8.19).Conclusions: Most patients had anemia at enrollment, of whom nearly 40% had microcytosis and hypochromia suggestive of iron deficiency. The mean hemoglobin increased significantly in patients who received ART, but one third were still anemic 12 months after ART initiation indicating that additional interventions to treat HIV-associated anemia in rural Africa might be warranted, particularly in patients with microcytosis and those treated with zidovudine. © 2011 Johannessen et al; licensee BioMed Central Ltd.
Authors & Co-Authors
Johannessen, Asgeir
Norway, Oslo
Ulleval University Hospital
Naman, Ezra
Tanzania, Mbulu
Haydom Lutheran Hospital
Gundersen, Svein Gunnar
Norway, Kristiansand
Sørlandet Hospital
Norway, Kristiansand
Universitetet I Agder
Bruun, Johann Nikolai
Norway, Oslo
Ulleval University Hospital
Norway, Tromso
Uit Norges Arktiske Universitet
Norway, Tromso
Universitetssykehuset Nord-norge
Statistics
Citations: 77
Authors: 4
Affiliations: 6
Identifiers
Doi:
10.1186/1471-2334-11-190
e-ISSN:
14712334
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cohort Study
Case-Control Study
Study Locations
Tanzania
Participants Gender
Male
Female