title: Prevalence, incidence and risk factors of anaemia in HIV-positive and HIV-negative drug users.
abstract: 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.
authors.affiliation: Municipal Health Service, Division of Public Health and Environment, Amsterdam, The Netherlands. bvbenthem@gggd.amsterdam.nl
authors.forename: M J
authors.initials: MJ
authors.lastname: van der Werf
authors.forename: B H
authors.initials: BH
authors.lastname: van Benthem
authors.forename: E J
authors.initials: EJ
authors.lastname: van Ameijden
mesh_terms: 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*