原创力文档antiretroviral treatment reverses hiv-associated anemia in rural tanzania抗逆转录病毒治疗逆转艾滋病在农村坦桑尼亚贫血.pdfVIP
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antiretroviral treatment reverses hiv-associated anemia in rural tanzania抗逆转录病毒治疗逆转艾滋病在农村坦桑尼亚贫血
Johannessen et al. BMC Infectious Diseases 2011, 11:190
/1471-2334/11/190
RESEARCH ARTICLE Open Access
Antiretroviral treatment reverses HIV-associated
anemia in rural Tanzania
1* 2 3,4 1,5,6
Asgeir Johannessen , Ezra Naman , Svein G Gundersen and Johan N Bruun
Abstract
Background: HIV-associated anemia is common and associated with poor prognosis. However, its response to
antiretroviral treatment (ART) in rural Africa is poorly understood.
Methods: HIV-infected adults (≥15 years) who enrolled in HIV care at Haydom Lutheran Hospital in northern
Tanzania were included in the study. The effect of ART (zidovudine/stavudine + lamivudine + efavirenz/nevirapine)
on HIV-associated anemia was studied in a subset of patients who were anemic at the time they started ART and
had a follow-up hemoglobin measurement 12 months later. Pregnant women were excluded from the study, as
were women who had given birth within the past 6 weeks. Anemia was defined as hemoglobin 12 g/dL in
women and 13 g/dL in men. We applied paired sample T-tests to compare hemoglobin levels before and one
year after ART initiation, and logistic regression models to identify predictors of persistent anemia.
Results: At enrollment, mean hemoglobin was 10.3 g/dL, and 649 of 838 patients (77.4%) were anemic. Of the
anemic patients, 254 (39.1%) had microcytosis and hypochromia. Among 102 patients who were anemic at ART
initiation and had a follow-up hemoglobin measurement after 12 months, the mean hemoglobin increased by 2.5
g/dL (P 0.001); however, 39 patients (38.2%) were still anemic after 12 months of ART. Independent predictors of
persistent anemia were mean cell volume in the lower quartile (76.0 fL; Odds Ratio [OR] 4.34; 95% confidence
interval
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