Tamir Zemenu, Alemu Jemal, Tsegaye Aster
Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Ethiop J Health Sci. 2018 Jan;28(1):73-82. doi: 10.4314/ejhs.v28i1.9.
Hematological complications such as Zidovudine(ZDV) associated anemia are among the commonly reported adverse drug reactions of Antiretroviral Therapy(ART). Little is known about ZDV associated anemia in developing countries like Ethiopia.
Comparative retrospective cohort study was conducted at the ART Clinic of St. Paul Hospital Millennium Medical College from February 2011 to December 2012 to characterize anemia among HIV/AIDS patients initiated with ZDV and non-ZDV containing ART regimens. In each group, 197 HIV infected adults who had complete medical records were included. Medical records of participants were reviewed using pre-tested data collection format. Data were analyzed using SPSS version 19 for windows. For all statistical significance tests, the cut-off value was P<0.05.
Among ZDV group, anemia prevalence was 20.8 % (41/197), 33.5%(66 /197) and 13%(19/146) at baseline, six and twelve months of ART follow-up, respectively.On the other hand in non-ZDV group, anemia was present among 44.2% (87/197), 18.3% (36/197) and 12.4% (25 /202) of participants at baseline, six and twelve months of ART follow-up, respectively. After six months of follow-up, ZDV associated anemia was present among 32.7% (51/156) of the participants, and 43.1% of them were severe while about 45.2% were macrocytic type. Zidovudine group participants were 3.34 times more likely to develop severe anemia than non-ZDV group, P< 0.001.
The prevalence, severity and characteristics of anemia were different between ZDV and non-ZDV group participants at different follow-up periods of ART. Zidovudine had significant contribution to severe anemia incidence after six months of ART; thus, hemoglobin level monitoring with red cell indices is suggested for improved detection of zidovudine associated anemia.
血液学并发症，如齐多夫定（ZDV）相关贫血，是抗逆转录病毒疗法（ART）常见的药物不良反应。在埃塞俄比亚等发展中国家，对于ZDV相关贫血知之甚少。
2011年2月至2012年12月，在圣保罗医院千禧医学院的抗逆转录病毒治疗诊所进行了一项比较性回顾性队列研究，以描述开始使用含ZDV和不含ZDV的抗逆转录病毒治疗方案的艾滋病毒/艾滋病患者中的贫血情况。每组纳入197名有完整病历的艾滋病毒感染成年人。使用预先测试的数据收集格式对参与者的病历进行审查。使用Windows版SPSS 19对数据进行分析。所有统计学显著性检验的临界值为P<0.05。
在ZDV组中，ART随访基线、6个月和12个月时贫血患病率分别为20.8%（41/197）、33.5%（66/197）和13%（19/146）。另一方面，在非ZDV组中，ART随访基线、6个月和12个月时贫血患病率分别为44.2%（87/197）、18.3%（36/197）和12.4%（25/202）。随访6个月后，32.7%（51/156）的参与者出现ZDV相关贫血，其中43.1%为重度贫血，约45.2%为大细胞型。Zidovudine组参与者发生重度贫血的可能性是非ZDV组的3.34倍，P<0.001。
在ART不同随访期，ZDV组和非ZDV组参与者贫血的患病率、严重程度和特征不同。Zidovudine对ART 6个月后的重度贫血发生率有显著影响；因此，建议监测血红蛋白水平和红细胞指数，以更好地检测Zidovudine相关贫血。
