Development of Severe Anemia and Changes in Hemoglobin in a Cohort of HIV-Infected Ugandan Adults Receiving Zidovudine-, Stavudine-, and Tenofovir-Containing Antiretroviral Regimens.

Parkes-Ratanshi, Rosalind; Katende, David; Levin, Jonathan; Wakeham, Katie; Heiner, Grosskurth; Kamali, Anatoli; Lalloo, David G; (2014) Development of Severe Anemia and Changes in Hemoglobin in a Cohort of HIV-Infected Ugandan Adults Receiving Zidovudine-, Stavudine-, and Tenofovir-Containing Antiretroviral Regimens. Journal of the International Association of Providers of AIDS Care, 14 (5). pp. 455-462. ISSN 2325-9574 DOI: https://doi.org/10.1177/2325957414557264

Abstract

INTRODUCTION: Anemia is a common problem in HIV in sub-Saharan Africa. We describe the contribution of antiretroviral therapy (ART) regimen to the incidence of anemia and changes in hemoglobin (Hb) in HIV-infected patients in Uganda. METHODS: This study was nested in a prevention of cryptococcal disease trial (CRYPTOPRO; ISCRTN7648152). Patients received 3 different backbones of nucleoside reverse transcriptase inhibitor in a nonrandomized manner. RESULTS: Of the 852 patients (161 on zidovudine [ZDV], 628 on stavudine [d4T], and 63 on tenofovir [TDF]; all received lamuvidine), the risk of developing grade 4 anemia was higher (adjusted hazard ratio 2.7) for those receiving ZDV than those receiving d4T. Those receivingd4T had a higher average increase in Hb than those receiving ZDV (P = .024) or TDF (P = .014). CONCLUSION: In this observational study, ZDV was associated with severe anemia compared to d4T or TDF; those receiving ZDV and TDF had smaller increases in Hb after ART initiation. We encourage publication of data on cohorts using TDF from Africa.

Additional Information

Item Type	Article
Faculty and Department	Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre	Tropical Epidemiology Group
PubMed ID	25425638
Related URLs	OA Location