Journal of Blood Medicine (Oct 2020)
Anemia in HIV/AIDS Patients on Antiretroviral Treatment at Ayder Specialized Hospital, Mekele, Ethiopia: A Case-Control Study
Abstract
Yemane Berhane,1 Diresibachew Haile,2 Tesfaye Tolessa2 1Department of Biomedical Science, College of Medicine and Health Science, Adigrat University, Adigrat, Northern Ethiopia, Ethiopia; 2Department of Medical Physiology, School of Medicine, College of Medicine and Health Science, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Yemane BerhaneDepartment of Biomedical Science, College of Medicine and Health Science, Adigrat University, P. O. Box 50, Adigrat, Northern Ethiopia, EthiopaEmail [email protected]: Human immunodeficiency virus and anemia are the major public health problems in Sub-Sahara Africa. Untreated anemia is associated with rapid progression and poor prognosis of the disease in HIV. This study was aimed at determining the magnitude, severity and associated factors of anemia among HIV infected patients taking zidovudine and tenofovir-containing first-line HAART in Ayder Comprehensive Specialized Hospital, Mekele, Ethiopia.Methods: A case-control study was conducted from February to August 2019 using both convenient and quota sampling methods. Anemia is defined as hemoglobin value below 13 g/dl for male and below 12 g/dl for female. Sociodemographic and clinical characteristics were assessed using a structured questionnaire, medical records, electronic weighing scale, adult height board, automated hematology analyzer (Sysmex XT-4000i), and Becton Dickinson’s FACS caliber flow cytometer. Descriptive statistics, tables, graphs, Student’s t-test and l logistic regression were used to analyze the data.Results: About one-third (33.5%) of study participants were found to be anemic (ZDV: 20.3%; TDF: 13.2%, and p< 0.05). Among these anemic cases, the majority was found to have mild, and the remaining was moderate types. The most common form was normocytic-normochromic anemia (46.5%). Cotrimoxazole prophylaxis, poor adherence, advanced AIDS stage at baseline and underweight at baseline were the factors associated with anemia in patients taking zidovudine-containing regimen (p< 0.05). Advanced stage at baseline, cotrimoxazole prophylaxis, poor adherence status and lack of regular income were significantly associated with anemia in patients taking tenofovir-containing regimen (p< 0.05).Conclusion: We find that the prevalence of anemia was significantly higher among patients taking ZDV-containing regimen. But different risk factors for anemia had been identified among ZDV-containing regimen, showing that appropriate follow-up, nutritional supplementation, continuous evaluation of patients on cotrimoxazole intake can reduce the risks of anemia in both types of regimens.Keywords: HIV/AIDS, tenofovir, zidovudine, anemia, Ethiopia
