Anaemia and its associated risk factors among patients with human immunodeficiency virus attending Muhimbili National Hospital - medical department

Abstract

Background: Human Immunodeficiency Virus (HIV) infection is associated with significant haematological abnormalities. In this study anaemia and associated risk factors were evaluated among HIV-infected in-patients and outpatients attending the HIV care and treatment clinic of the Medical department Methods: A standardised questionnaire was used to obtain information on social-demographic characteristics, clinical history, and information on anti-retroviral therapy. Patients were staged according to WHO guidelines and CD4 counts determined. Anaemia was determined from a complete blood count. Iron status was established using transferrin concentration, serum iron and serum ferritin levels, and serum B12 and folate were analyzed. Univariate and multivariate logistic regression were used to determine the association between anaemia and associated risk factors.

Results: A total of 316 HIV-infected patients were recruited. Anaemia was significantly higher among the no income (63.1%) and low income (54%) compared to the medium income (42.4%) and high income (37.5%) patients, p=0.047. Severity of anaemia increased with advanced stage of HIV infection and low CD4 count (p= 0.0001 and p=0.0001 respectively). Patients who were not on any anti-retroviral therapy were found to have higher prevalence of anaemia compared to those on therapy, 68.1% vs 49.3%: with those on AZT containing regimes having a higher prevalence of anaemia 50.3% compared to those on non-AZT containing regimes 47.4% (p=0.0001). Low serum folate and low iron were found to be associated with anaemia (p=0.002 and 0.0001 respectively). On multivariate analysis history of blood transfusion since HIV diagnosis, thrombocytosis, ,low CD4 count and low serum iron were predictors of anaemia.

Conclusion and recommendation: The risk factors for anaemia among HIV-infected patients are multifactorial. Treatment of anaemia in HIV infection should include initiating anti-retroviral therapy together with administration of iron and folic acid supplements.