The National Clinical Key Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University.
Biosci Trends. 2017 Jan 16;10(6):445-453. doi: 10.5582/bst.2016.01165. Epub 2016 Nov 26.
Anemia is one of the most important complications of HIV infection. In China, the prevalence, risk factors, and association between anemia and prognosis in HIV-infected patients are poorly elucidated. We analyzed data from 3452 HIV-infected patients not yet on combined antiretroviral therapy (cART) attending Beijing Ditan Hospital from June, 2003 to December, 2015. The overall prevalence of anemia was 9.8% (7.6% mild, 1.9% moderate, and 0.2% severe anemia). Female sex (odds ratio [OR] = 3.71, 95% confidence interval [CI]: 1.46-6.51, p = 0.003), age 40-59 years (OR = 2.54, 95% CI: 1.59-4.05, p < 0.001), body mass index < 18.5 kg/m (OR = 2.23, 95% CI: 1.31-3.79, p = 0.003), baseline HIV RNA CI: 1.32-5.99, p = 0.007) were risk factors for anemia. Age 40-59 years (adjusted hazard ratio [AHR] = 5.76, 95% CI: 1.62-20.55, p = 0.007), and anemia ‒ mild (AHR = 7.46, 95% CI: 1.48-37.50, p = 0.015), moderate (AHR = 9.89, CI: 1.35-72.38, p = 0.024), and severe (AHR = 28.29, 95% CI: 2.75-290.54, p = 0.005) anemia ‒ were associated with an increased hazard of death. In this cohort, mild anemia was most common. Anemia was associated with female sex, older age, lower body mass index, lower baseline CD4 count, and higher viral load. Moreover, anemia was associated with an increased risk of death. These findings should promote awareness among physicians to make a timely diagnosis of HIV and to help physicians prioritize prevention and intervention strategies for anemia in HIV-infected patients.
贫血是 HIV 感染的最重要并发症之一。在中国，HIV 感染者贫血的患病率、危险因素以及与预后的关系尚未阐明。我们分析了 2003 年 6 月至 2015 年 12 月在北京地坛医院未接受联合抗逆转录病毒治疗（cART）的 3452 名 HIV 感染者的数据。贫血的总体患病率为 9.8%（7.6%为轻度贫血，1.9%为中度贫血，0.2%为重度贫血）。女性（比值比[OR] = 3.71，95%置信区间[CI]：1.46-6.51，p = 0.003）、年龄 40-59 岁（OR = 2.54，95%CI：1.59-4.05，p < 0.001）、体重指数<18.5 kg/m（OR = 2.23，95%CI：1.31-3.79，p = 0.003）、基线 HIV RNA 拷贝数 1.32-5.99，p = 0.007）是贫血的危险因素。年龄 40-59 岁（调整后的危险比[AHR] = 5.76，95%CI：1.62-20.55，p = 0.007）和贫血（轻度[AHR = 7.46，95%CI：1.48-37.50，p = 0.015]、中度[AHR = 9.89，CI：1.35-72.38，p = 0.024]和重度[AHR = 28.29，95%CI：2.75-290.54，p = 0.005]）与死亡风险增加相关。在本队列中，轻度贫血最常见。贫血与女性、年龄较大、较低的体重指数、较低的基线 CD4 计数和较高的病毒载量相关。此外，贫血与死亡风险增加相关。这些发现应促使医生提高对 HIV 的认识，并帮助医生优先制定 HIV 感染者贫血的预防和干预策略。
