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Low body mass index increases risk of anemia in patients with HIV-AIDS receiving antiretroviral therapy

Mirna Widiyanti, Reynold Ubra, Eva Fitriana
Submission date: Monday, 03 April 2017
Published date: Monday, 27 November 2017
DOI: http://dx.doi.org/10.18051/UnivMed.2017.v36.221-227

Abstract


Background
In acquired immunodeficiency syndrome (AIDS) cases, cytopenias of all major blood cell lines were increasingly recognized in patients with HIV infection. Anemia commonly occurs during HIV infection and has been associated with increased progression to AIDS and decreased survival. The aim of this study was to determine the prevalence of anemia and associated risk factors in adults with HIV-AIDS receiving antiretroviral therapy (ART).

Methods
A cross sectional study was conducted involving 90 adults with HIV-AIDS. Sociodemographic data were collected using a questionnaire. In all patients, CD4+ lymphocyte counts were performed by means of a PIMA analyzer, while hemoglobin was determined using a Sysmex hematology analyzer. The WHO cutoff value of hemoglobin was adjusted to altitude to define anemia. Mild to moderate anemia was defined as hemoglobin 8-13 g/dL for men and 8-12 g/dL for women. Severe anemia was defined as hemoglobin 8 g/dL. Data was analyzed by using logistic regression test.

Results
There were 90 subjects with HIV-AIDS in this study. Anemia was found in 50 subjects (55.6%), consisting of 12.2% with mild anemia and 43.4% with moderate to severe anemia. Multiple logistic regression showed that an important risk factor for anemia was low body mass index (BMI) between <17-18.5 (OR=4.20; 95% CI=1.23-14.36). However, the CD4 <350 cells/mm3 was not a significant risk factor for anemia (OR=1.03; 95% CI=0.21-5.04).

Conclusions
Low BMI increases the risk of anemia in subjects with HIV receiving ART. Better screening for anemia and infectious diseases, and modified harm reduction strategy for injection drug users are primary needs in HIV patients.

Keywords


Anemia; body mass index; CD4+; HIV-AIDS

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References


Sharp PM, Hahn BH. Origins of HIV and the AIDS pandemic. Cold Spring Harb Perspect Med 2011;1:1-22.

Direktorat Jenderal Pemberantasan Penyakit Menular dan Penyehatan Lingkungan. 2014 Statistik kasus HIV/AIDS di Indonesia. Jakarta : Kementerian Kesehatan RI;2014.

Kulkarni MB, Bhalerao MM, Mungal SU, et al. Anemia in subjects living with HIV/AIDS: a cross sectional study from India. IOSR J Dent Med Sci 2015;14:4-8.

Ndlovu Z, Chirwa T, Takuva S. Incidence and predictors of recovery from anemia within an HIV-infected South African cohort 2004-2010. Pan African Med J 2014;19:114-20.

Takuva S, Maskew M, Brennan AT, et al. Anemia among HIV-infected patients initiating antiretroviral therapy in South Africa : improvement in hemoglobin regardless of degree of immunosuppresion and the initiating ART regimen. J Trop Med 2013. Article ID 162950.

Jam S, Ramezani A, Sabzvari D, et al. A crosssectionel study of anemia in human immunodeficiency virus-infected patients in Iran. Arch Iranian Med 2009;12:145-50.

World Health Organization. Hemoglobin concentrarion for the diagnosis of anemia and assesment of severity. Geneva: World Health Organization;2011.

World Health Organization. Worldwide prevalence of anemia 1993-2005: WHO global database on anemia. Geneva: World Health Organization;2008.

Meidani M, Rezaei F, Maracy MR, et al. Prevalence, severity, and related factors of anemia in HIV/AIDS patients. J Res Med Sci 2012;17:138-42.

Pande A, Bhattacharyya M, Pain S, et al. Anemia in antiretroviral naive HIV/AIDS patients: a study from Eastern India. J Health Allied Sci 2011;10:1-4.

World Health Organization. WHO issues new HIV recommendations calling for earlier treatment. Geneva : World Health Organization;2013.

Wisaksana R, Sumantri R , Indrati AR, et al. Anemia and iron homeostasis in a cohort of HIV-infected patients in Indonesia. BMC Infect Dis 2011;11:213.

Sumantri R, Wicaksana R, Ariantana AR. Prevalensi dan faktor risiko anemia pada HIV-AIDS. MKB 2009;41:187-92.

Subbaraman R, Anemia among HIV-infected in South India [dissertation]. New Haven: The Yale University of Medicine;2007.

Bradley SEK, Mishra V. HIV and nutrition among women in sub-Saharan Africa. DHS Analytical Studies No. 16. Calverton, Maryland, USA: Macro International Inc.;2008.

Ramezani A, Aghakhan A, Sharif MZ, et al. Anemia prevalence and related factors in HIV-infected patients; a cohort study. Iranian J Phathol 2008;3:128-8.

Gragnolati M, Shekar M, Gupta M. India’s undernourished children: a call for reform and action. Washington, D.C : The World Bank ; 2005.

Takuva S, Louwagie G, Zuma K, et al. Durability of first line antiretroviral therapy: reasons and predictive factors for modification in a Swaziland cohort. J Antivir Antiretrovir 2012;4:14-20.

Mata-Marín JA, Gaytán-Martínez JE, Martínez-Martínez RE, et al. Risk factors and correlates for anemia in HIV treatment-naïve infected patients: a cross-sectional analytical study. BMC Res Notes 2010;3:230.

Alavi SM, Ahmadi F, Farhadi M. Correlation between total lymphocyte count, hemoglobin, hematocrit and CD4 count in HIV/AIDS patients. Acta Medica Iranica 2009;47:1-4.

Zhou J, Jaquet A, Bissagenene E. Short-term risk of anaemia following initiation of combination antiretroviral treatment in HIV-infected patients in countries in sub-Saharan Africa, Asia-Pacific, and central and South America, J Int AIDS Society 2012;15:5.

Subbaraman R, Devaleena B, Selvamuthu P, et al. Factors associated with anemia in HIV infected individuals in Southern India. Int J STD AIDS 2009;20:489-92.


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