UNC Project, Tidziwe Centre, Private Bag, A-104, Lilongwe, Malawi.
University of North Carolina Schools of Medicine and Public Health, Chapel Hill, North Carolina, USA.
BMC Infect Dis. 2018 Jan 15;18(1):39. doi: 10.1186/s12879-018-2952-9.
Anemia is common among people living with HIV infection and is frequently associated with poor quality of life and poor prognosis. It has been well described in antiretroviral naïve individuals and those on non-nucleoside reverse transcriptase inhibitor-based first line antiretroviral therapy (ART) regimens. However there is limited information on anemia for ART experienced individuals on protease inhibitor-based second line ART regimens in resource limited settings. Our objective was to describe the prevalence and risk factors of anemia in this ART experienced population in Malawi.
We conducted a cross-sectional study using routine facility data at two HIV clinics in Lilongwe, Malawi. The analysis included individuals receiving protease inhibitor-based second line ART. Clinical and laboratory data were collected at routine clinic visits. We used descriptive statistics, two-sample t-tests and multivariate logistic regression for data analysis.
Three hundred seventy-seven records were included in this analysis (37% male, median age 41 years, median CD4 count 415 cells/μL). The prevalence of anemia was 125/377 (33.2%) - mild, moderate and severe anemia was 17.5%, 13.8%, and 1.9% respectively. Female participants had a higher prevalence than male participants (43.6% vs. 15.7%, p < 0.001). In multivariate logistic regression, female sex (adjusted odds ratio (aOR) 5.3; 95% CI 2.9-9.5) and a CD4 count <200 cell/ul (aOR 3.1; 95%CI 1.6-6.0) were associated with increased risk of having anemia while a BMI ≥30 kg/m2 (aOR 0.8; 95% CI 0.6-1.0) and being on ART for more than 10 years (aOR 0.4; 95% CI 0.2-0.9) were associated with reduced risk of anemia. Being on a zidovudine- containing ART regimen was not associated with anemia.
Anemia is common in people on second line ART in Lilongwe, Malawi. Screening for anemia in this population would be a useful strategy; especially for female patients, those who are underweight and have a low CD4 cell counts.
贫血在感染艾滋病毒的人群中很常见，常与生活质量差和预后不良有关。在抗逆转录病毒初治个体和接受基于非核苷类逆转录酶抑制剂的一线抗逆转录病毒治疗（ART）方案的个体中，贫血已经得到了很好的描述。然而，在资源有限的环境中，关于接受蛋白酶抑制剂为基础的二线 ART 方案的 ART 经验个体的贫血信息有限。我们的目的是描述马拉维两个艾滋病毒诊所中接受 ART 经验的人群中贫血的患病率和危险因素。
我们在马拉维利隆圭的两个艾滋病毒诊所进行了一项横断面研究，使用常规机构数据。分析包括接受蛋白酶抑制剂为基础的二线 ART 的个体。在常规诊所就诊时收集临床和实验室数据。我们使用描述性统计、两样本 t 检验和多变量逻辑回归进行数据分析。
本分析共纳入 377 份记录（37%为男性，中位年龄 41 岁，中位 CD4 计数 415 个/μL）。贫血的患病率为 125/377（33.2%）-轻度、中度和重度贫血的患病率分别为 17.5%、13.8%和 1.9%。女性参与者的患病率高于男性参与者（43.6%比 15.7%，p<0.001）。在多变量逻辑回归中，女性（调整后的优势比（aOR）5.3；95%置信区间（95%CI）2.9-9.5）和 CD4 计数<200 个/μL（aOR 3.1；95%CI 1.6-6.0）与贫血风险增加相关，而 BMI≥30 kg/m2（aOR 0.8；95%CI 0.6-1.0）和接受 ART 治疗超过 10 年（aOR 0.4；95%CI 0.2-0.9）与贫血风险降低相关。接受含齐多夫定的 ART 方案与贫血无关。
在马拉维利隆圭接受二线 ART 的人群中，贫血很常见。在该人群中筛查贫血将是一种有用的策略；特别是对于女性患者、体重不足和 CD4 细胞计数低的患者。
