Background:
The objective was to examine the short-term risk and predictors of anaemia following initiation of combination antiretroviral therapy (cART) in HIV-infected patients from the Western Africa, Eastern Africa, Southern Africa, Central Africa, Asian-Pacific, and Caribbean and Central and South America regions of the International Epidemiologic Databases to Evaluate AIDS (IeDEA) collaboration.
Methods:
Anaemia was defined as haemoglobin of <10g/dL. Patients were included if they started cART with three or more drugs, had prior haemoglobin of >=10g/dL, and had one or more follow-up haemoglobin tests. Factors associated with anaemia up to 12 months were examined using Cox proportional hazards models and stratified by IeDEA region.
Results:
Between 1998 and 2008, 19,947 patients initiated cART with baseline and follow-up haemoglobin tests (7358, 7289, 2853, 471, 1550 and 426 in the Western Africa, Eastern Africa, Southern Africa, Central Africa, Asian-Pacific, and Caribbean and Central and South America regions, respectively). At initiation, anaemia was found in 45% of Western Africa patients, 29% of Eastern Africa patients, 21% of Southern Africa patients, 36% of Central Africa patients, 15 of patients in Asian-Pacific and 14 % of patients in Caribbean and Central and South America. Among patients with haemoglobin of >=10g/dL at baseline (13,445), the risks of anaemia were 18.2, 6.6, 9.7, 22.9, 11.8 and 19.5 per 100 person-years in the Western Africa, Eastern Africa, Southern Africa, Central Africa, Asian, and Caribbean and Central and South America regions, respectively. Factors associated with anaemia were female sex, low baseline haemoglobin level, low baseline CD4 count, more advanced disease stage, and initial cART containing zidovudine.
Conclusions:
In data from 34 cohorts of HIV-infected patients from sub-Saharan Africa, Central and South America, and Asia, the risk of anaemia within 12 months of initiating cART was moderate. Routine haemoglobin monitoring was recommended in patients at risk of developing anaemia following cART initiation.
Go to Source
Related posts:
- Almost 7 million pregnant in sub-Saharan Africa infected with hookworms; at risk of anaemia
- Cohort Profile: The PharmAccess African (PASER-M) and the TREAT Asia (TASER-M) Monitoring Studies to Evaluate Resistance–HIV drug resistance in sub-Saharan Africa and the Asia-Pacific.
- Cohort Profile: The PharmAccess African (PASER-M) and the TREAT Asia (TASER-M) Monitoring Studies to Evaluate Resistance–HIV drug resistance in sub-Saharan Africa and the Asia-Pacific.
- Reducing mortality with cotrimoxazole preventive therapy at initiation of antiretroviral therapy in South Africa.
- Long-term adherence to antiretroviral treatment and program drop-out in a high-risk urban setting in sub-saharan Africa: a prospective cohort study.
