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埃塞俄比亚成年艾滋病病毒感染者中的贫血症:一项基于医院的横断面研究。

Anemia among adult HIV patients in Ethiopia: a hospital-based cross-sectional study.

作者信息

Melese Hermela, Wassie Molla Mesele, Woldie Haile, Tadesse Abilo, Mesfin Nebiyu

机构信息

HIV Follow-up Care Clinic, Debre-Tabor Hospital, Debre-Tabor.

Department of Human Nutrition, Institute of Public Health.

出版信息

HIV AIDS (Auckl). 2017 Feb 14;9:25-30. doi: 10.2147/HIV.S121021. eCollection 2017.

Abstract

BACKGROUND

Anemia is a major public health problem in HIV patients around the world. It has a negative effect on the quality of life of HIV patients and progression of the HIV disease. In the sub-Saharan African setting, including Ethiopia where both HIV infection and under-nutrition are expected to be high, there is a paucity of data on the matter. This study was aimed to reveal the magnitude and factors associated with anemia among adult HIV patients in Debre-Tabor Hospital, northwest Ethiopia.

METHODS

A hospital-based cross-sectional study was used among adult HIV patients in Debre-Tabor Hospital from April 1 to May 30, 2015. The diagnosis of anemia was made following the 2011 World Health Organization recommendation on hemoglobin cut-off points. Univariable and multivariable logistic regression was carried out to assess factors associated with anemia.

RESULTS

A total of 377 patients' charts were reviewed. Most of the participants (n=237, 62.9%) were taking antiretroviral treatment (ART). The overall prevalence of anemia was 23% (95% CI: 19.1, 27.6). Being ART-naïve (adjusted odds ratio [AOR]: 3.37; 95% CI: 1.59, 7.14), having treatment history with anti-tuberculosis (TB) drug (AOR: 3.2; 95% CI: 1.19, 8.67), taking zidovudine (ZDV)-containing ART regimen (AOR: 2.14; 95% CI: 1.03, 4.57), and having recent CD4+ T-lymphocytes count of <200 cells/μL (AOR: 2.13; 95% CI: 1.04, 4.36) were associated with occurrence of anemia among adult HIV patients.

CONCLUSION AND RECOMMENDATION

Anemia continues to be a major co-morbidity among adult HIV patients in Ethiopia. Adult HIV patients who are taking ZDV-containing ART, with a history of TB treatment, have a low CD4+T-lymphocytes count and are ART-naïve should be carefully screened and treated for anemia.

摘要

背景

贫血是全球艾滋病患者面临的一个主要公共卫生问题。它对艾滋病患者的生活质量和艾滋病病情进展有负面影响。在撒哈拉以南非洲地区,包括预计艾滋病毒感染和营养不良率都很高的埃塞俄比亚,关于这一问题的数据匮乏。本研究旨在揭示埃塞俄比亚西北部德布雷塔博尔医院成年艾滋病患者中贫血的严重程度及相关因素。

方法

2015年4月1日至5月30日,在德布雷塔博尔医院对成年艾滋病患者开展了一项基于医院的横断面研究。根据2011年世界卫生组织关于血红蛋白临界值的建议进行贫血诊断。采用单变量和多变量逻辑回归分析来评估与贫血相关的因素。

结果

共查阅了377份患者病历。大多数参与者(n = 237,62.9%)正在接受抗逆转录病毒治疗(ART)。贫血的总体患病率为23%(95%置信区间:19.1,27.6)。未接受过抗逆转录病毒治疗(调整后的优势比[AOR]:3.37;95%置信区间:1.59,7.14)、有抗结核(TB)药物治疗史(AOR:3.2;95%置信区间:1.19,8.67)、采用含齐多夫定(ZDV)的抗逆转录病毒治疗方案(AOR:2.14;95%置信区间:1.03,4.57)以及近期CD4 + T淋巴细胞计数<200个细胞/μL(AOR:2.13;95%置信区间:1.04,4.36)与成年艾滋病患者贫血的发生相关。

结论与建议

在埃塞俄比亚,贫血仍是成年艾滋病患者的一个主要合并症。对于正在接受含ZDV的抗逆转录病毒治疗、有结核治疗史、CD4 + T淋巴细胞计数低且未接受过抗逆转录病毒治疗的成年艾滋病患者,应仔细筛查并治疗贫血。

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