Health  Vol.7 No.12 , December 2015
Anemia and Its Associated Risk Factors at the Time of Antiretroviral Therapy Initiation in Public Health Facilities of Arba Minch Town, Southern Ethiopia
Abstract: Background: Anemia is the most common hematologic abnormality in HIV patients and is associated with disease progression and decreased survival. This study aims to describe the prevalence and predictors of anemia in HIV positive patients at the time of ART initiation at public health facilities of Arba Minch town, Southern Ethiopia. Methods: A total of 411 adults (?15 years) HIV positive patients with complete information on hemoglobin levels and CD4 count and clinical characteristics registered from 2006 to 2013 were assessed for anemia prevalence and risk factors at the ART clinic of the Arba Minch hospital and health center. The measurements of Hemoglobin and CD4 + T cell count were performed using standard methodology at baseline of ART initiation. Results: A total of 411 HIV positive patients (195 males and 216 females) with a mean ± SD age of 33.9 ± 9.0 years were assessed. Hemoglobin levels were between 6.0 and 16.5 mg/dL. The overall prevalence of anemia at the time of ART initiation was 52.3%; with 28.1%, 22.9% and 1.3% mild, moderate and severe anemia respectively. The overall prevalence of anemia was 62.4% among males and 46.7% among females (P < 0.001). An increased risk of anemia was seen in males (adjusted OR = 2.78, 95% CI = 1.77 - 4.35); low CD4 cell counts (adjusted OR = 3.48, 95% CI = 2.09 - 5.79); and history of TB (adjusted OR = 2.89, 95% CI = 1.28 - 6.54). Conclusions: Anemia in HIV-positive patients was highly prevalent at the time of ART initiation. Male gender, low CD4 count and history of TB were associated with higher risk of baseline anemia.
Cite this paper: Alamdo, A. , Fiseha, T. , Tesfay, A. , Deber, M. , Tirfe, Z. , Tilahun, T. (2015) Anemia and Its Associated Risk Factors at the Time of Antiretroviral Therapy Initiation in Public Health Facilities of Arba Minch Town, Southern Ethiopia. Health, 7, 1657-1664. doi: 10.4236/health.2015.712179.

[1]   Bain, B.J. (1997) The Haematological Features of HIV Infection. Review. British Journal of Haematology, 99, 1-8.

[2]   Mehta, S., Jutur, S. and Gautam, D. (2011) Hematologic Manifestations of HIV/AIDS. Medicine Update-2011.

[3]   Volberding, P., Baker, K. and Levine, A. (2003) Human Immunodeficiency Virus Hematology. Hematology Am Soc Hematol Educ Program, 2003, 294-313.

[4]   Sharma, S. (2014) Normocytic Norm Chromic Anemia Is Most Common Type Anemia HIV Infected Patients. JMSCR, 2, 1249-1255.

[5]   Amanda, J. and Nancy Berliner, R. (2013) Pathogenesis and Clinical Implications of HIV-Related Anemia in 2013. Hematology, the Education Program, 2013, 377-381.

[6]   Belperio, P. and Rhew, D. (2004) Prevalence and Outcomes of Anemia in Individuals with Human Immunodeficiency Virus: A Systematic Review of the Literature. American Journal of Medicine, 116, 27-43.

[7]   Mocroft, A., Kirk, O., Barton, S.E., Dietrich, M., Proenca, R., Colebunders, R., et al. (1999) Anaemia Is an Independent Predictive Marker for Clinical Prognosis in HIV-Infected Patients from across Europe. AIDS, 13, 943-450.

[8]   Sullivan, P., Hanson, D., Chu, S., Jones, J. and Ward, J. (1998) Epidemiology of Anemia in Human Immunodeficiency Virus (HIV)-Infected Persons: Results from the Multistate Adult and Adolescent Spectrum of HIV Disease Surveillance Project. Blood, 91, 301-308.

[9]   Obirikorang, C. and Yeboah, F. (2009) Blood Hemoglobin Measurements as a Predictive Indicator for the Progression of HIV/AIDS in Resource-Limited Setting. Journal of Biomedical Science, 16, 102.

[10]   Ferede, G. and Wondimeneh, Y. (2013) Prevalence and Related Factors of Anemia in HAART-Naive HIV Positive Patients at Gondar University Hospital, Northwest Ethiopia. BMC Hematology, 13, 8.

[11]   Shen, Y., Wang, Z., Lu, H., Wang, J., Chen, J., Liu, L., et al. (2013) Prevalence of Anemia among Adults with Newly Diagnosed HIV/AIDS in China. PLoS ONE, 8, e73807.

[12]   Denue, B., Kida, I., Hammagabdo, A., Dayar, A. and Sahabi, M. (2013) Prevalence of Anemia and Immunological Markers in HIV-Infected Patients on Highly Active Antiretroviral Therapy in Northeastern Nigeria. Infectious Diseases: Research and Treatment, 6, 25-33.

[13]   Daka, D., Lelissa, D. and Amsalu, A. (2013) Prevalence of Anaemia before and after the Initiation of Antiretroviral Therapy at ART Centre of Hawassa University Referral Hospital, Hawassa, South Ethiopia. Sch J Med., 3, 1-6.

[14]   Mildvan, D., Creagh, T. and Leitz, G., Anemia Prevalence Study Group (2007) Prevalence of Anemia and Correlation with Biomarkers and Specific Antiretroviral Regimens in 9690 Human-Immunodeficiency-Virus-Infected Patients: Findings of the Anemia Prevalence Study. Current Medical Research and Opinion, 23, 343-355.

[15]   Lawson, L., Yassin, M.A., Thacher, T.D., Olatunji, O.O., Lawson, J.O., Akingbogun, T.I., et al. (2008) Clinical Presentation of Adults with Pulmonary Tuberculosis with and without HIV Infection in Nigeria. Scandinavian Journal of Infectious Diseases, 40, 30-35.

[16]   Whalen, C.C., Nsubuga, P., Okwera, A., Johnson, J.L., Hom, D.L., Michael, N.L., et al. (2000) Impact of Pulmonary Tuberculosis on Survival of HIV-Infected Adults: A Prospective Epidemiologic Study in Uganda. AIDS, 14, 1219-1228.