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Prevalence and Predictors of Anemia in HIV-Infected Persons in Nepal

Authors Sah SK, Dahal P, Tamang GB, Mandal DK, Shah R, Pun SB

Received 6 January 2020

Accepted for publication 13 May 2020

Published 2 June 2020 Volume 2020:12 Pages 193—200


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Bassel Sawaya

Shiv Kumar Sah,1 Prastuti Dahal,1 Gyan Bahadur Tamang,1 Dipendra Kumar Mandal,2 Rajesh Shah,2 Sher Bahadur Pun2

1Purbanchal University, Little Buddha College of Health Science, Kathmandu, Nepal; 2Sukraraj Tropical and Infectious Disease Hospital, Teku, Kathmandu, Nepal

Correspondence: Shiv Kumar Sah
Purbanchal University, Little Buddha College of Health Science, Minbhawan, Kathmandu, Nepal

Background: Anemia is the commonest hematological complications in HIV patients, and has a significant impact on quality of life, morbidity, and mortality. However, little is known about the epidemiology of anemia in this population in a Nepalese setting. Therefore, the present study aimed at assessing the prevalence of anemia in patients living with HIV and further to determine the independent predictors associated with it.
Methods: This cross-sectional study was conducted in patients diagnosed with HIV at Sukraraj Tropical and Infectious Disease Hospital, Teku, Kathmandu from November 2016 to August 2017. Anemia was considered a core variable, and covariates used for analysis were age, sex, CD4 count, antiretroviral therapy regimen, history of intravenous drug use, marital status, religion, geography, employment status, hypertension, and diabetes mellitus. Prevalence of anemia and its independent predictors were evaluated. Fisher’s exact and χ2 tests were performed to determine the significance of differences among categorical variables and t-tests for continuous variables. Binary logistic regression was modeled to assess predictors associated with anemia.
Results: Of the total 210 patients analyzed, median age was 37.50± 10.57 years, and 110 (52.6%) were male. The estimated prevalence of anemia overall was 66.7% (95% CI 60.64%– 73.35%): mild anemia 14.3% (95% CI 8.25%– 19.74%), moderate anemia 40.5% (95% CI 31.88%– 48.11%), and severe anemia 11.9% (95% CI 6.61%– 17.30%). Prevalence of anemia increased significantly with decreasing CD4 count: 5.71%, 12.85%, and 48.09% among patients with CD4 counts > 500, 200– 499, and < 200 cells/mm3, respectively (P=0.019). Severity of anemia was significantly associated with immunostatus (< 200, 200– 499, and > 500; P=0.048). Female sex was significantly associated with increased odds of anemia (OR 2.27, P=0.007).
Conclusion: The present study demonstrated a high rate of anemia in a substantial number of HIV individuals. Therefore, early detection and timely management of anemia, especially in females and those with decreased immunostatus, are crucial to prevent anemia progression and improve quality of life.

Keywords: anemia, HIV, risk factors

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