High prevalence of iron deficiency and anemia among female injection drug users with and without HIV infection.

Abstract

Anemia is associated with increased progression of disease and higher mortality during HIV infection. To determine the prevalence of iron deficiency and iron deficiency anemia among female injection drug users (IDUs) with and without HIV infection. Hemoglobin and plasma ferritin were measured in a cross-sectional study of a cohort of female IDUs followed in Baltimore, Maryland. Among 136 HIV-positive and 61 HIV-negative women, the prevalence of anemia was 44.1% and 26.2% ( p <.02), the prevalence of iron deficiency was 37.5% and 42.6% ( p =.49), and the prevalence of iron deficiency anemia was 20.6% and 14.7% ( p =.33), respectively. The overall prevalence of hepatitis C infection was 90.5%. Iron deficiency anemia accounted for 46.7% and 56.1% of the anemia among HIV-positive and HIV-negative female IDUs. Iron deficiency accounts for about half of the anemia among female IDUS. Although iron supplementation is indicated for anemia patients, such treatment should be approached with caution in women coinfected with HIV and hepatitis C virus, because iron supplementation and overload have been associated with increased progression of HIV infection, worsening of hepatitis C virus infection, and higher mortality.