Short-term risk of anaemia following initiation of combination antiretroviral treatment in HIV-infected patients in countries in sub-Saharan Africa, Asia-Pacific, and central and South America
نویسندگان
چکیده
BACKGROUND The objective was to examine the short-term risk and predictors of anaemia following initiation of combination antiretroviral therapy (cART) in HIV-infected patients from the Western Africa, Eastern Africa, Southern Africa, Central Africa, Asian-Pacific, and Caribbean and Central and South America regions of the International Epidemiologic Databases to Evaluate AIDS (IeDEA) collaboration. METHODS Anaemia was defined as haemoglobin of < 10 g/dL. Patients were included if they started cART with three or more drugs, had prior haemoglobin of > = 10 g/dL, and had one or more follow-up haemoglobin tests. Factors associated with anaemia up to 12 months were examined using Cox proportional hazards models and stratified by IeDEA region. RESULTS Between 1998 and 2008, 19,947 patients initiated cART with baseline and follow-up haemoglobin tests (7358, 7289, 2853, 471, 1550 and 426 in the Western Africa, Eastern Africa, Southern Africa, Central Africa, Asian-Pacific, and Caribbean and Central and South America regions, respectively). At initiation, anaemia was found in 45% of Western Africa patients, 29% of Eastern Africa patients, 21% of Southern Africa patients, 36% of Central Africa patients, 15% of patients in Asian-Pacific and 14% of patients in Caribbean and Central and South America. Among patients with haemoglobin of > = 10 g/dL at baseline (13,445), the risks of anaemia were 18.2, 6.6, 9.7, 22.9, 11.8 and 19.5 per 100 person-years in the Western Africa, Eastern Africa, Southern Africa, Central Africa, Asian, and Caribbean and Central and South America regions, respectively. Factors associated with anaemia were female sex, low baseline haemoglobin level, low baseline CD4 count, more advanced disease stage, and initial cART containing zidovudine. CONCLUSIONS In data from 34 cohorts of HIV-infected patients from sub-Saharan Africa, Central and South America, and Asia, the risk of anaemia within 12 months of initiating cART was moderate. Routine haemoglobin monitoring was recommended in patients at risk of developing anaemia following cART initiation.
منابع مشابه
Challenges and Proposed Actions for HIV/AIDS Control among Children in Iran
It is estimated globally 3.2 million children were living with HIV in 2014, that mostly in sub-Saharan Africa. However, the majority of them infected to HIV from their mothers during pregnancy, during delivery or breastfeeding (1). Antiretroviral therapy (ART) use during and after pregnancy is essential for prevention of mother-to-child transmission (PMTCT) of HIV (2). In the absence of any in...
متن کاملAntiretroviral therapy in resource-limited settings 1996 to 2006: patient characteristics, treatment regimens and monitoring in sub-Saharan Africa, Asia and Latin America.
OBJECTIVES To describe temporal trends in baseline clinical characteristics, initial treatment regimens and monitoring of patients starting antiretroviral therapy (ART) in resource-limited settings. METHODS We analysed data from 17 ART programmes in 12 countries in sub-Saharan Africa, South America and Asia. Patients aged 16 years or older with documented date of start of highly active ART (H...
متن کاملFinancing for Healthcare in Sub-Saharan Africa and South Asia: Risk Pooling & Risk-Sharing Arrangements; Essential Strategy for Overcoming Poverty Costs
متن کامل
Early mortality among adults accessing antiretroviral treatment programmes in sub-Saharan Africa.
Two-thirds of the world's HIV-infected people live in sub-Saharan Africa, and more than 1.5 million of them die annually. As access to antiretroviral treatment has expanded within the region; early pessimism concerning the delivery of antiretroviral treatment using a large-scale public health approach has, at least in the short term, proved to be broadly unfounded. Immunological and virological...
متن کاملMetabolic Abnormalities in HIV-Positive Patients Receiving Highly Active Antiretroviral Therapy
Background and Objective: Dyslipidemia has become a common problem in human immunodeficiency virus (HIV) disease, especially in patients on combination antiretroviral therapy. In this study we aimed to determine the prevalence of dyslipidemia and metabolic abnormalities in 2 groups of HIV infected patients receiving highly activ...
متن کامل