Incidence and risk factors of anaemia among people on antiretroviral therapy in Harare.

Southern African journal of HIV medicine Pub Date : 2024-08-30 eCollection Date: 2024-01-01 DOI:10.4102/sajhivmed.v25i1.1605
Linda A Mandikiyana Chirimuta, Tinei Shamu, Cleophas Chimbetete, Chérie Part
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Abstract

Background: Anaemia is associated with reduced quality of life and increased mortality risk among people living with HIV (PLHIV). Although antiretroviral therapy (ART) reduces the prevalence of anaemia, some patients remain at risk after commencing ART.

Objectives: We estimated the incidence of anaemia after ART commencement and identified associated risk factors.

Method: We analysed outpatient records at Newlands Clinic, Harare, Zimbabwe. Patients (≥ 5 years old) who were commenced on ART between January 2016 and December 2020 were included and were followed up for up to 2 years. Patients with anaemia at ART commencement and women who were pregnant at any time during follow-up were excluded. Cox proportional hazards regression was used to assess independent risk factors for anaemia.

Results: During the study, 1110 patients ≥ 5 years old were commenced on ART with a prevalence of anaemia of 40.0%. Five hundred and twenty-nine patients met the inclusion criteria and were followed up for 823.7 person-years. The median age was 36.1 years and 290 (58.4%) were female. The incidence rate of anaemia after ART commencement was 176.1 per 1000 person-years (95% confidence interval [CI]: 149.6-207.2). Females (aHR: 2.09; 95% CI: 1.46-3.00, P < 0.001), zidovudine use (aHR: 3.50 96% CI: 2.14-5.71, P < 0.001), age 5-12 years or > 50 years, and the presence of World Health Organization stage III/IV disease (aHR: 2.19; 95% CI: 1.14-5.71, P = 0.019) had higher odds of developing anaemia.

Conclusion: The incidence of anaemia after ART commencement was high. Female sex, zidovudine use, age and the presence of stage III/IV disease were independent risk factors for anaemia. Clinicians should screen PLHIV on ART regularly for anaemia.

哈拉雷接受抗逆转录病毒治疗的人群中贫血的发生率和风险因素。
背景:贫血与艾滋病病毒感染者(PLHIV)生活质量下降和死亡风险增加有关。尽管抗逆转录病毒疗法(ART)降低了贫血的发病率,但一些患者在开始接受抗逆转录病毒疗法后仍面临贫血风险:我们估算了抗逆转录病毒疗法开始后贫血的发生率,并确定了相关的风险因素:我们分析了津巴布韦哈拉雷纽兰兹诊所的门诊记录。我们纳入了在 2016 年 1 月至 2020 年 12 月期间开始接受抗逆转录病毒疗法的患者(≥ 5 岁),并对其进行了长达 2 年的随访。开始接受抗逆转录病毒疗法时患有贫血症的患者以及在随访期间怀孕的妇女均被排除在外。采用 Cox 比例危险回归评估贫血的独立风险因素:研究期间,1110 名年龄≥ 5 岁的患者开始接受抗逆转录病毒疗法,贫血发生率为 40.0%。有 529 名患者符合纳入标准,并接受了 823.7 年的随访。中位年龄为 36.1 岁,290 人(58.4%)为女性。抗逆转录病毒疗法开始后的贫血发生率为每千人年 176.1 例(95% 置信区间 [CI]:149.6-207.2)。女性(aHR:2.09;95% CI:1.46-3.00,P <0.001)、使用齐多夫定(aHR:3.50 96% CI:2.14-5.71,P <0.001)、年龄在 5-12 岁或 50 岁以上、患有世界卫生组织 III/IV 期疾病(aHR:2.19;95% CI:1.14-5.71,P = 0.019)的患者发生贫血的几率更高:结论:抗逆转录病毒疗法开始后贫血的发生率很高。结论:抗逆转录病毒疗法开始后贫血的发生率很高,女性、使用齐多夫定、年龄和患有 III/IV 期疾病是导致贫血的独立风险因素。临床医生应定期对接受抗逆转录病毒疗法的艾滋病毒感染者进行贫血筛查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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