Department of Pharmacy, Wollo University, Dessie, Ethiopia.
PLoS One. 2022 Mar 25;17(3):e0265337. doi: 10.1371/journal.pone.0265337. eCollection 2022.
Although antiretroviral therapy has significantly altered the natural history of human immunodeficiency virus infection and improved the quality of life of patients, there are conflicting reports regarding its impact on hematological outcomes. Thus, this study aimed at investigating the prevalence and predictors of anemia among adults on antiretroviral therapy in Northeast Ethiopia.
A retrospective cohort study was carried out among adults who began antiretroviral treatment between September 2005 and January 2019 at two governmental hospitals in Dessie town. Data were collected from patients' medical records using a pretested data extraction instrument. Anemia was the primary outcome variable of the study. It was defined based on WHO criteria after adjustment for altitude and smoking status of measured values. Data were entered and validated using EpiData Version 3.1 and then exported to SPSS Version 20.0 for analysis. Descriptive analysis was done for prevalence and binary logistic regression was carried out to assess whether covariates were associated with experiencing anemia. Statistical significance has been considered at p-value <0.05.
Medical records of 392 patients (mean age: 35.58 ± 9.46 years) were reviewed. Of the total 392 patients, 218 (55.6%) were females, 261 (66.6%) were categorized under WHO clinical stage III/IV and 134 (34.2%) had a baseline CD4 cell count of <100 cells/mm3. The mean baseline CD4 cell count was 179 cells/mm3 (range: 2 to 853 cells) and 230 (58.7%) of the participants were on zidovudine-based regimen. Anemia was diagnosed among 162 (41.3%) patients. After adjustment for other confounding factors, risk of anemia was significantly associated with low baseline CD4 cell count (AOR 1.80, 95% CI 1.05-3.06) and tenofovir based regimen (AOR 2.05, 95% CI 1.31-3.21). On the other hand, being educated was found to be protective (AOR 0.40, 95% CI 0.21-0.78).
In this research, the prevalence of anemia was relatively high. Low baseline CD4 cell count and tenofovir based regimen were independent predictors of anemia; while being educated was protective. Treatment programs should focus on early diagnosis and treatment of HIV as well as routine screening and proper treatment of anemia.
尽管抗逆转录病毒疗法显著改变了人类免疫缺陷病毒感染的自然史并提高了患者的生活质量，但关于其对血液学结果的影响仍存在相互矛盾的报告。因此，本研究旨在调查东北埃塞俄比亚接受抗逆转录病毒治疗的成年人贫血的患病率和预测因素。
这是一项在德西镇的两家政府医院于 2005 年 9 月至 2019 年 1 月期间开始接受抗逆转录病毒治疗的成年人中进行的回顾性队列研究。使用经过预测试的数据提取工具从患者的病历中收集数据。该研究的主要结局变量是贫血。根据世界卫生组织的标准，在对测量值的海拔和吸烟状态进行调整后定义了贫血。数据使用 EpiData 版本 3.1 输入和验证，然后导出到 SPSS 版本 20.0 进行分析。进行了描述性分析，并进行了二元逻辑回归以评估协变量是否与贫血的发生相关。统计显著性被认为是 p 值 <0.05。
共回顾了 392 名患者（平均年龄：35.58 ± 9.46 岁）的病历。在总共 392 名患者中，218 名（55.6％）为女性，261 名（66.6％）被归类为世界卫生组织临床分期 III/IV 期，134 名（34.2％）的基线 CD4 细胞计数<100 个细胞/mm3。基线 CD4 细胞计数的平均值为 179 个细胞/mm3（范围：2 至 853 个细胞），230 名（58.7％）参与者接受齐多夫定为基础的方案。诊断出 162 名（41.3％）患者贫血。在调整其他混杂因素后，贫血的风险与低基线 CD4 细胞计数（AOR 1.80，95％CI 1.05-3.06）和基于替诺福韦的方案（AOR 2.05，95％CI 1.31-3.21）显著相关。另一方面，受教育程度被发现具有保护作用（AOR 0.40，95％CI 0.21-0.78）。
在这项研究中，贫血的患病率相对较高。低基线 CD4 细胞计数和基于替诺福韦的方案是贫血的独立预测因素；而受教育程度则具有保护作用。治疗方案应侧重于早期诊断和治疗 HIV 以及常规筛查和适当治疗贫血。
