HIV symptom burden and anemia among HIV-positive individuals: cross-sectional results of a community-based positive living with HIV (POLH) study in Nepal.

Catherine Martin,Krishna C Poudel,Kalpana Poudel-Tandukar,Julian W Tang

doi:10.1371/journal.pone.0116263

Catherine Martin, Krishna C Poudel + Show 2 more

Open Access

https://doi.org/10.1371/journal.pone.0116263

Copy DOI

Journal: PloS one	Publication Date: Dec 31, 2014
Citations: 64	License type: CC BY 4.0

Affiliation: University of Massachusetts Amherst

Abstract

BackgroundPrevious research has reported high rates of anemia in people living with HIV/AIDS (PLWHA) in hospital or tertiary care settings. The objective of this community-based study was to measure the prevalence of anemia and describe the risk factors, with a specific emphasis on HIV symptom burden, in PLWHA in the Kathmandu Valley, Nepal.MethodsWe conducted a cross-sectional survey of 319 PLWHA residing in the Kathmandu Valley, Nepal. We recruited participants from five non-governmental organizations in the Kathmandu Valley. Descriptive statistics and multivariable logistic regression analyses were used.ResultsOur study found a 55.8% prevalence of anemia in PLWHA in the Kathmandu Valley. The prevalence of anemia among the participants with first, second, third, and fourth quartiles of HIV symptom burden was 44.8%, 49.3%, 60.3%, and 69.6%, respectively. Compared to the participants with lowest level of HIV symptom burden, the participants with highest level of HIV symptom burden were more likely to have anemia (adjusted odds ratio = 2.14; 95% confidence interval = 1.07 to 4.30).ConclusionDue to a high prevalence of anemia in a community-based sample of PLWHA, HIV patients should be counseled on their risk of developing anemia and encouraged to seek timely care for HIV symptoms.

Highlights

Anemia is an important contributor to morbidity and mortality among people living with HIV/AIDS (PLWHA)
Comparing rates of anemia among PLWHA from different studies is complicated by variations in a number of factors including stage of HIV disease, use of ART, and definition of anemia, results from a review of the literature suggest that rates of anemia in PLWHA in a number of subpopulations tend to be higher in developing countries than in developed countries [4]
Of the 233 participants on ART, 226 (96.9%) were under two Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs; any two of Lamivudine, Stavudine, and Zidovudine) and one Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs; either Efavirenz or Nevirapine), 6 (2.6%) were under two NRTIs (Didanosine and Tenofovir) and one Protease Inhibitor (PI; Lopinavir/Ritonavir), and one participant was under three NRTIs (Abacavir, Lamivudine, and Zidovudine)

Summary

Introduction

Anemia is an important contributor to morbidity and mortality among people living with HIV/AIDS (PLWHA). Even among people living with HIV but without clinical AIDS, estimates of anemia are high and range from 18%–82.7% [3, 4, 6, 7]. Previous research has reported high rates of anemia in people living with HIV/AIDS (PLWHA) in hospital or tertiary care settings. The objective of this community-based study was to measure the prevalence of anemia and describe the risk factors, with a specific emphasis on HIV symptom burden, in PLWHA in the Kathmandu Valley, Nepal. Conclusion: Due to a high prevalence of anemia in a community-based sample of PLWHA, HIV patients should be counseled on their risk of developing anemia and encouraged to seek timely care for HIV symptoms

Methods

Results

Conclusion