Anemia among HIV Infected Individuals Taking ART with and without Zidovudine at Addis Ababa, Ethiopia.

Abstract

Hematological complications such as Zidovudine(ZDV) associated anemia are among the commonly reported adverse drug reactions of Antiretroviral Therapy(ART). Little is known about ZDV associated anemia in developing countries like Ethiopia. Comparative retrospective cohort study was conducted at the ART Clinic of St. Paul Hospital Millennium Medical College from February 2011 to December 2012 to characterize anemia among HIV/AIDS patients initiated with ZDV and non-ZDV containing ART regimens. In each group, 197 HIV infected adults who had complete medical records were included. Medical records of participants were reviewed using pre-tested data collection format. Data were analyzed using SPSS version 19 for windows. For all statistical significance tests, the cut-off value was P<0.05. Among ZDV group, anemia prevalence was 20.8 % (41/197), 33.5%(66 /197) and 13%(19/146) at baseline, six and twelve months of ART follow-up, respectively.On the other hand in non-ZDV group, anemia was present among 44.2% (87/197), 18.3% (36/197) and 12.4% (25 /202) of participants at baseline, six and twelve months of ART follow-up, respectively. After six months of follow-up, ZDV associated anemia was present among 32.7% (51/156) of the participants, and 43.1% of them were severe while about 45.2% were macrocytic type. Zidovudine group participants were 3.34 times more likely to develop severe anemia than non-ZDV group, P< 0.001. The prevalence, severity and characteristics of anemia were different between ZDV and non-ZDV group participants at different follow-up periods of ART. Zidovudine had significant contribution to severe anemia incidence after six months of ART; thus, hemoglobin level monitoring with red cell indices is suggested for improved detection of zidovudine associated anemia.