title: Improvement of anemia among HIV-infected injection drug users receiving highly active antiretroviral therapy.
abstract: Although anemia is common during HIV infection, it is unclear whether potent antiretroviral therapy would improve or worsen anemia. We conducted a study to examine the impact of highly active antiretroviral therapy (HAART) on anemia in a cohort of HIV-positive injection drug users (IDUs) in Baltimore, Maryland. At baseline, the overall prevalence of anemia was 40%. During mean follow-up of one year, among 102 subjects who received HAART, there was a mean increase in hemoglobin of 3.6 +/- 1.7 g/L (p =.0003) [corrected] and a mean decrease in log(10) plasma HIV load of 0.25 +/- 0.06 copies/ml (p <.0002) [corrected]. Among 103 control subjects who were not receiving antiretroviral medications, there was a mean decrease in hemoglobin of 4.2 +/- 1.1 g/L (p <.04) [corrected] and mean increase in log(10) plasma HIV load of 0.78 +/- 0.17 copies/ml (p <.0001) [corrected]. Multivariate analysis using mixed linear models showed that HAART was associated with an increase of hemoglobin of 0.223 g/L per month (p <.0001) after adjusting for body mass index, opportunistic infections, and gender. HAART was associated with an improvement in anemia, and potential mechanisms that may be involved include a reduction in opportunistic infections and the anemia of chronic disease and an improvement in nutritional status.
authors.affiliation: Department of Ophthalmology, Schools of Medicine, Johns Hopkins University, Baltimore, Maryland, USA. rdsemba@jhmi.edu
authors.forename: R D
authors.initials: RD
authors.lastname: Semba
authors.forename: N
authors.initials: N
authors.lastname: Shah
authors.forename: D
authors.initials: D
authors.lastname: Vlahov
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000821:virology; D000328:Adult; D000740:Anemia / Q000097:blood / Q000150:complications* / Q000188:drug therapy* / Q000821:virology; D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D015142:Baltimore; D015992:Body Mass Index; D018791:CD4 Lymphocyte Count; D002908:Chronic Disease; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000187:drug effects / Q000502:physiology; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D012737:Sex Factors; D015819:Substance Abuse, Intravenous / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D006454:Hemoglobins