Prevalence and risk factors of anaemia in hospitalised HIV-infected patients in southeast China: a retrospective study.

J L Lai,Y M Liu,H H Ye,J Lin,J J Yuan,Y H Chen,A Q Huang

doi:10.1017/s0950268818003618

J L Lai, Y M Liu + Show 5 more

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https://doi.org/10.1017/s0950268818003618

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Abstract

The association between opportunistic infection (OI) and anaemia among HIV-infected patients remains to be studied. We investigated the prevalence and risk factors of anaemia in hospitalised HIV-infected patients to reveal the association between OI and anaemia. We conducted a retrospective study of HIV-positive hospitalised patients from June 2016 to December 2017 in Mengchao Hepatobiliary Hospital of Fujian Medical University. Patients' information on socio-demographic and clinical characteristics were carefully collected. The comparison of anaemia prevalence between groups was conducted with χ2 test. A logistic regression model was carried out to analyse the predictors of anaemia. The total prevalence of anaemia in hospitalised HIV-infected patients was 55.15%. The prevalence of mild, moderate and severe anaemia was 41.42%, 11.08% and 2.64%, respectively. Predictors independently associated with anaemia were: CD4 counts <50 cells/μl (odds ratio (OR): 6.376, 95% confidence interval (CI) = 1.916-21.215, P = 0.003), CD4 counts 50-199 cells/μl (OR: 6.303, 95% CI = 1.874-21.203, P = 0.003), co-infection with tuberculosis (TB) (OR: 2.703, 95% CI = 1.349-5.414, P = 0.005) or Penicillium marneffei (PM) (OR: 7.162, 95% CI = 3.147-15.299, P < 0.001). In Fujian, China, more than half inpatients with HIV were anaemic, but severe anaemia is infrequent. Lower CD4 counts, co-infection with TB or PM were independent risk factors for anaemia. Chinese HIV patients especially with TB, PM infection and low CD4 level should be routinely detected for anaemia to improve therapy.

Highlights

Anaemia is a major complication in HIV patients and leads to a poor quality of life, progression of the HIV disease, shorter life expectancy [1]
Due to different study settings, the prevalence of anaemia in the HIV patients ranges from 20% to 84% [5,6,7] in the world and the risk factors are different including sex, age, educational status, antiretroviral therapy (ART) status, stage of HIV disease, CD4+ T lymphocyte count, HIV RNA loads and presence of opportunistic infection (OI) [7,8,9,10]
In China, the prevalence of anaemia ranges from 9.8% to 51% in various regions depending on different geographical-social-economic conditions

Summary

Introduction

Anaemia is a major complication in HIV patients and leads to a poor quality of life, progression of the HIV disease, shorter life expectancy [1]. Dai et al [11] analysed data from 3452 ART-naive HIV-infected patients of Beijing Ditan Hospital in China, and revealed that the overall prevalence of anaemia was only 9.8% They found that female, older age, lower body mass index (BMI) and higher load of HIV RNA were associated with a higher prevalence of anaemia. While Shen and colleagues [12] reported that the overall prevalence of anaemia among Chinese adults newly diagnosed with HIV-infection was 51.9% In these cases, anaemia was associated with minority ethnicity, older age and lower CD4 counts. Another study [13] indicated that 38.9% of HIV-infected individuals in Xinjiang, China, were anaemic at the initiation of ART It suggested that Uyghur ethnicity, female, lower CD4 counts, lower BMI, self-reported tuberculosis (TB) infection and oral candidiasis were the risk factors of anaemia

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