Agegnehu Chilot Desta, Merid Mehari Woldemariam, Yenit Melaku Kindie
School of Nursing, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
HIV AIDS (Auckl). 2021 Apr 29;13:455-466. doi: 10.2147/HIV.S280338. eCollection 2021.
Globally, anemia is a common hematological disorder among HIV-infected patients. People with anemia often suffer from impaired physical functioning, psychological distress, and poor quality of life. Therefore, the aim of this study was to determine the incidence of anemia and its determinants among HIV positive individuals in northwest Ethiopia.
A total of 486 adult HIV positive patients on the first-line ART with complete information were enrolled in the adult care clinics of northwest Amhara referral hospitals from December 2015 to December 2018. EpiData version 4.2 was used for data entry and Stata version 14 for analysis. Variables having time to event nature were presented with the Kaplan-Meier function. The Cox regression model was used to identify predictors of anemia. Variables with P-values less than 0.2 in the bivariable analysis were considered in the multivariable regression. Adjusted hazard ratio with 95% CI was computed, and variables with less than 0.05 P-values in the multivariable Cox regression were taken as significant predictors of anemia.
This study noted an overall 26.4 per 100 person-year observations (95% CI: 23.46, 30.74) incidence rate of anemia. According to the multivariable Cox regression, TB co-infection (AHR =1.99, 95% CI: 1.45, 2.74), zidovudine-based regimen (AHR=1.39, 95CI: 1.1, 1.85), CD4 level (AHR= 1.7, 95% CI: 1.23, 2.35), advanced WHO stage (AHR=1.32, 95% CI: 1.01, 1.74), and being underweight (AHR= 1.53, 95% CI: 1.14, 2.07) were predictors of anemia.
Anemia is a burden among HIV patients in the study setting. Baseline clinical variables, TB co-infection, and zidovudine-based were predictors of anemia. Therefore, early identification of anemia and addressing significant predictors are highly suggested to the study setting.
在全球范围内，贫血是HIV感染患者中常见的血液系统疾病。贫血患者常伴有身体机能受损、心理困扰和生活质量低下。因此，本研究的目的是确定埃塞俄比亚西北部HIV阳性个体中贫血的发病率及其决定因素。
2015年12月至2018年12月期间，共有486名一线抗逆转录病毒治疗（ART）且信息完整的成年HIV阳性患者被纳入西北阿姆哈拉转诊医院的成人护理诊所。使用EpiData 4.2版本进行数据录入，Stata 14版本进行分析。具有事件发生时间性质的变量用Kaplan-Meier函数表示。采用Cox回归模型确定贫血的预测因素。在多变量回归中考虑双变量分析中P值小于0.2的变量。计算调整后的风险比及95%置信区间，多变量Cox回归中P值小于0.05的变量被视为贫血的显著预测因素。
本研究发现贫血的总体发病率为每100人年观察26.4例（95%置信区间：23.46，30.74）。根据多变量Cox回归，合并结核感染（调整后风险比[AHR]=1.99，95%置信区间：1.45，2.74）、基于齐多夫定的治疗方案（AHR=1.39，95%置信区间：1.1，1.85）、CD4水平（AHR=1.7，95%置信区间：1.23，2.35）、世界卫生组织（WHO）晚期（AHR=1.32，95%置信区间：1.01，1.74）和体重过轻（AHR=1.53, 95%置信区间：1.14，2.07）是贫血的预测因素。
在本研究环境中，贫血是HIV患者的一个负担。基线临床变量、合并结核感染和基于齐多夫定的治疗方案是贫血的预测因素。因此，强烈建议在本研究环境中早期识别贫血并解决显著的预测因素。
