Prevalence, Incidence and Predictors of Severe Anaemia with Zidovudine-Containing Regimens in African Adults With HIV Infection within the DART trial
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Date
2006
Journal Title
Journal ISSN
Volume Title
Publisher
Antiviral therapy
Abstract
To describe the prevalence, incidence and predictors of severe anaemia in previously untreated symptomatic HIV-infected adults with CD4+ T-cells <200 cells/mm3 initiating zidovudine-containing regimens in Africa. DART is a randomized trial comparing two strategies for HIV/AIDS management in Uganda and Zimbabwe.We analysed the occurrence of anaemia at weeks 4 and 12, and then every 12 weeks. We also evaluated sex, age, WHO stage, body mass index (BMI), baseline laboratory measurements and first regimen aspredictors of developing grade 4 anaemia (<6.5 mg/dl) by week 48 using logistic regression. To May 2005, 3,314 participants (65% women, 23% at WHO stage 4, median age=37 years, baseline CD4+ T-cell=86 cells/mm3 and median baseline haemoglobin=11.4 g/dl) had a median 72 weeks follow-up. Prevalence of grade 4 anaemia was 0.7%, 2.0%, 0.5% and <0.5% at weeks 4, 12, 24 and ≥36, respectively. Overall, 219 (6.6%) participants developed grade 4 anaemia by week 48; women and those with lower haemoglobin, CD4+ T-cell count and BMI at baseline were at significantly higher risk (P<0.05), but not those
with lower neutrophils or receiving cotrimoxazole at baseline. We observed a higher incidence of grade 4 anaemia than in studies from industrialized countries, which is likely to be due in part to population characteristics and in part to a higher rate of concurrent HIV-related clinical events. Clinical vigilance and haemoglobin measurements 4, 8 and 12 weeks after starting zidovudine could help to manage serious anaemia.
Description
Keywords
DART, Anaemia, HIV
Citation
Ssali, F., Stöhr, W., Munderi, P., Reid, A., Walker, A. S., Gibb, D. M., ... & Gilks, C. F. (2006). Prevalence, incidence and predictors of severe anaemia with zidovudine-containing regimens in African adults with HIV infection within the DART trial. doi/10.1177/135965350601100612therapy, 11(6), 741-750.