Mandikiyana Chirimuta Linda A, Shamu Tinei, Chimbetete Cleophas, Part Chérie
Newlands Clinic, Harare, Zimbabwe.
Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom.
South Afr J HIV Med. 2024 Aug 30;25(1):1605. doi: 10.4102/sajhivmed.v25i1.1605. eCollection 2024.
Anaemia is associated with reduced quality of life and increased mortality risk among people living with HIV (PLHIV). Although antiretroviral therapy (ART) reduces the prevalence of anaemia, some patients remain at risk after commencing ART.
We estimated the incidence of anaemia after ART commencement and identified associated risk factors.
We analysed outpatient records at Newlands Clinic, Harare, Zimbabwe. Patients (≥ 5 years old) who were commenced on ART between January 2016 and December 2020 were included and were followed up for up to 2 years. Patients with anaemia at ART commencement and women who were pregnant at any time during follow-up were excluded. Cox proportional hazards regression was used to assess independent risk factors for anaemia.
During the study, 1110 patients ≥ 5 years old were commenced on ART with a prevalence of anaemia of 40.0%. Five hundred and twenty-nine patients met the inclusion criteria and were followed up for 823.7 person-years. The median age was 36.1 years and 290 (58.4%) were female. The incidence rate of anaemia after ART commencement was 176.1 per 1000 person-years (95% confidence interval [CI]: 149.6-207.2). Females (aHR: 2.09; 95% CI: 1.46-3.00, < 0.001), zidovudine use (aHR: 3.50 96% CI: 2.14-5.71, < 0.001), age 5-12 years or > 50 years, and the presence of World Health Organization stage III/IV disease (aHR: 2.19; 95% CI: 1.14-5.71, = 0.019) had higher odds of developing anaemia.
The incidence of anaemia after ART commencement was high. Female sex, zidovudine use, age and the presence of stage III/IV disease were independent risk factors for anaemia. Clinicians should screen PLHIV on ART regularly for anaemia.
贫血与艾滋病毒感染者（PLHIV）的生活质量下降和死亡风险增加有关。尽管抗逆转录病毒疗法（ART）可降低贫血患病率，但一些患者在开始接受ART治疗后仍有风险。
我们估计了开始ART治疗后贫血的发生率，并确定了相关风险因素。
我们分析了津巴布韦哈拉雷纽兰兹诊所的门诊记录。纳入2016年1月至2020年12月开始接受ART治疗的患者（≥5岁），并随访长达2年。排除开始接受ART治疗时贫血的患者以及随访期间任何时候怀孕的女性。采用Cox比例风险回归评估贫血的独立危险因素。
在研究期间，1110名≥5岁的患者开始接受ART治疗，贫血患病率为40.0%。529名患者符合纳入标准，随访823.7人年。中位年龄为36.1岁，290名（58.4%）为女性。开始接受ART治疗后贫血的发病率为每1000人年176.1例（95%置信区间[CI]：149.6 - 207.2）。女性（调整后风险比：2.09；95% CI：1.46 - 3.00，P < 0.001）、使用齐多夫定（调整后风险比：3.50，96% CI：2.14 - 5.71，P < 0.001）、年龄在5 - 12岁或>50岁以及存在世界卫生组织III/IV期疾病（调整后风险比：2.19；95% CI：1.14 - 5.71，P = 0.019）发生贫血的几率更高。
开始接受ART治疗后贫血的发生率很高。女性、使用齐多夫定、年龄以及III/IV期疾病的存在是贫血的独立危险因素。临床医生应定期对接受ART治疗的PLHIV进行贫血筛查。
