title: High prevalence of iron deficiency and anemia among female injection drug users with and without HIV infection.
abstract: BACKGROUND
  Anemia is associated with increased progression of disease and higher mortality during HIV infection.
  
  
  OBJECTIVE
  To determine the prevalence of iron deficiency and iron deficiency anemia among female injection drug users (IDUs) with and without HIV infection.
  
  
  METHODS
  Hemoglobin and plasma ferritin were measured in a cross-sectional study of a cohort of female IDUs followed in Baltimore, Maryland.
  
  
  RESULTS
  Among 136 HIV-positive and 61 HIV-negative women, the prevalence of anemia was 44.1% and 26.2% ( p <.02), the prevalence of iron deficiency was 37.5% and 42.6% ( p =.49), and the prevalence of iron deficiency anemia was 20.6% and 14.7% ( p =.33), respectively. The overall prevalence of hepatitis C infection was 90.5%. Iron deficiency anemia accounted for 46.7% and 56.1% of the anemia among HIV-positive and HIV-negative female IDUs.
  
  
  CONCLUSIONS
  Iron deficiency accounts for about half of the anemia among female IDUS. Although iron supplementation is indicated for anemia patients, such treatment should be approached with caution in women coinfected with HIV and hepatitis C virus, because iron supplementation and overload have been associated with increased progression of HIV infection, worsening of hepatitis C virus infection, and higher mortality.
authors.affiliation: Department of Ophthalmology, School of Medicine and Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA. rdsemba@jhmi.edu
authors.forename: Richard D
authors.initials: RD
authors.lastname: Semba
authors.forename: Nina
authors.initials: N
authors.lastname: Shah
authors.forename: Steffanie A
authors.initials: SA
authors.lastname: Strathdee
authors.forename: David
authors.initials: D
authors.lastname: Vlahov
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D005260:Female; D005293:Ferritins / Q000097:blood; D015658:HIV Infections / Q000097:blood / Q000150:complications*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D000090463:Iron Deficiencies; D015995:Prevalence; D015819:Substance Abuse, Intravenous / Q000097:blood / Q000150:complications*
chemical_list: D006454:Hemoglobins; D005293:Ferritins