Anemia is a common side effect of antiretroviral therapy for HIV

1. Patients with HIV treated with antiretroviral  therapy (ART) have a 31.5% chance of being anemic with many significantly positively associated risk factors that can be easily screened for and monitored

Evidence Rating Level: 3 (Average)

Anemia is a significant cause of morbidity and mortality in individuals undergoing highly active antiretroviral therapy (HAART). An estimate showed 46.60% of all individuals living with HIV on HAART experience anemia with 1/3 North American patients having anemia. The aim of this retrospective cross-sectional study was to look at the prevalence of anemia in patients receiving HAART and more specifically tenofovir (TDF), lamivudine (3TC) or dolutegravir (TLD) as they were being rolled out as first-line therapy in Ethiopia. HIV-reactive adults (aged ≥18 years) on HAART (≥6 months) with complete information were enrolled. Patients with blood disorders, pregnant women, or women in the postpartum period (within 6 weeks of giving birth) were excluded from the study. Of the included participants, 31.5% were anemic with 2.2% having severe anemia. Using bivariate logistic regression analysis, many characteristics were positively associated anemia including age >40 years old, female sex, illiteracy, 6-10 years and >10 years lived with HIV, CD4+ T-lymphocyte count <200 cells/µL, and >10 years on ART. A multivariate binary logistic regression analysis showed >40 years old, female sex, >10 years lived with HIV, CD4+ T-lymphocyte count <200 cells/µL, and positive history of opportunistic infections as significantly positively associated factors. Therefore, when treating patients with HIV with tenofovir, lamivudine or dolutegravir, extra attention should be paid to the possibility of anemia in these patients. Socioeconomic factors should also be taken into account as factors such as primary schooling and illiteracy are significantly associated with anemia in HIV patients.

Click to read the study in BMJ Open

Image: PD

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