Prevalence, incidence and risk factors of anaemia in HIV-positive and HIV-negative drug users.
OBJECTIVE
To determine the prevalence of anaemia among HIV-positive and -negative drug users, estimate the incidence of anaemia among HIV-positive drug users and study risk factors for prevalent anaemia with emphasis on HIV infection, gender and drug use behaviour.


METHODS
Cross-sectional study among HIV-positive and HIV-negative drug users (n = 360) and a longitudinal study among HIV-positive drug users (n = 175, 860 visits) participating in a cohort study of drug users in Amsterdam.


METHODS
Self-reported data on socio-demographics, drug use behaviour and zidovudine and protease inhibitor therapy on regular cohort visits. Laboratory determinations of haemoglobin concentration, CD4(+)-cell counts and HIV-1 RNA.


RESULTS
The prevalence of anaemia was 21.1% among participating drug users according to the WHO definition. The incidence of anaemia in HIV-positive individuals was 33.0/100 person-years. The main risk factor for anaemia was high frequency of injecting drugs. A Quetelet body mass index < or = 20 and female gender were also positively and significantly related to anaemia in the cross-sectional study. In the longitudinal study among HIV-positive drug users progression of HIV infection indicated by low CD4(+)-cell count and AIDS diagnosis were predictive of anaemia.


CONCLUSIONS
The results indicate that drug users in the Amsterdam cohort study have a high prevalence of anaemia, which can be explained mainly by high frequency of injecting drugs and HIV infection progression. Reduction or cessation of injecting drug use should reduce anaemia.
van der Werf
M J
MJ
Municipal Health Service, Division of Public Health and Environment, Amsterdam, The Netherlands. bvbenthem@gggd.amsterdam.nl
van Benthem
B H
BH
van Ameijden
E J
EJ
D000328:Adult; D000704:Analysis of Variance; D000740:Anemia / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006679:HIV Seropositivity / Q000150:complications*; D015497:HIV-1; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D015819:Substance Abuse, Intravenous / Q000150:complications*