Associations of anemia, treatments for anemia, and survival in patients with human immunodeficiency virus infection.
Three large observational cohort studies suggest that, after controlling for virus load and CD4 cell count, anemia is related to disease progression and survival in patients with human immunodeficiency virus (HIV) infection. Recovery from anemia has been linked to improved survival outcomes. Blood transfusion has been associated with accelerated disease progression and mortality in patients with HIV infection, and review of related literature suggests that the mechanism for negative transfusion-associated outcomes may be transfusion-related immunosuppression. Therefore, the use of transfusion should be restricted to patients with acute or severe anemia. Prescription of epoetin alfa has been associated with increased survival in an observational cohort among patients with HIV infection and anemia. In the absence of data from a clinical trial documenting the effect of treating anemia on survival, clinicians should consider non-transfusion options for management of anemia on the basis of clinical status and patient functional ability.
Sullivan
Patrick
P
Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA.
D000740:Anemia / Q000209:etiology* / Q000628:therapy*; D001803:Blood Transfusion; D018450:Disease Progression; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000627:therapeutic use; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000401:mortality; D006397:Hematinics / Q000627:therapeutic use; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D011788:Quality of Life; D011994:Recombinant Proteins; D016019:Survival Analysis
D006397:Hematinics; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa