Anemia Is A Common, Serious Problem for HIV-Infected Women
Originally published by Reuters Health, February 8, 2002
NEW YORK (Reuters Health) — HIV-positive women are at very high risk for developing anemia, which is associated with a substantially increased mortality risk, according to a report published in the January 15th issue of Clinical Infectious Diseases.
Dr. Richard D. Semba, from Johns Hopkins University in Baltimore, and colleagues conducted a longitudinal study of 797 HIV-positive and 389 HIV-negative women to determine the prevalence and cumulative incidence of anemia and the relevant risk factors. The study began in 1993 and ended in 2000.
At enrollment, 28% of HIV-infected women were anemic compared with 15.1% of HIV-negative women (p < 0.0001). By the end of the study, 74% and 48% of HIV-positive and negative women, respectively, were anemic, the investigators found.
Multivariate analysis revealed that increasing age, African American race, CD4+ T cell count < 200 cells/ L, zidovudine use, lower body mass index, history of fever, oral candidiasis, and history of bacterial pneumonia were linked to an increased risk of anemia. However, after the introduction of highly active antiretroviral therapy (HAART) in 1996, zidovudine use and fever history were no longer significantly linked to anemia.
The mortality rates for HIV-positive women who were anemic and not anemic at enrollment were 37% and 22%, respectively. Multivariate analysis, controlling for body mass index and CD4+ T cell count < 200 cells/microliter, confirmed that anemic women were are increased for death, with a hazard ratio of 1.64.
"To our knowledge, this is the first study to demonstrate the cumulative incidence of anemia in a cohort of HIV-positive women, and these findings should alert clinicians to the extremely high risk of anemia for women during the course of HIV infection," the researchers state. It also appears to be the first study to extend the well-documented anemia-related mortality risk to HIV-positive women.
The authors believe that anemia may be the most common morbidity associated with HIV infection. Further studies are needed to investigate interventions that may reduce the risk of anemia in HIV-positive women, they add.
