Anemia and survival in human immunodeficiency virus.
The prospective, multicenter cohort study EuroSIDA has previously reported on predictors and outcomes of anemia in patients infected with human immunodeficiency virus. In a Cox proportional-hazards model with serial measures of CD4+ cell count, plasma viral load, and degrees of anemia fitted as time-dependent variables, the relative hazard of death increased markedly for patients with anemia versus no anemia. A clinical scoring system was developed and validated for patients receiving highly active antiretroviral therapy using the most recent laboratory measures. Mild and severe anemia were independently (P<.01) associated with clinical disease progression, with a relative hazard of disease progression of 2.2 (95% confidence interval [CI], 1.6-2.9) and 7.1 (95% CI, 2.5-20.1), respectively, compared with patients with no anemia. The mechanisms underlying why hemoglobin is such a strong prognostic marker and whether correction of anemia itself results in a better prognosis remain to be determined.
Copenhagen HIV Programme-044, Hvidovre University Hospital, Hvidovre, Denmark. jdl@cphiv.dk
Jens D
JD
Lundgren
Amanda
A
Mocroft
D000740:Anemia / Q000209:etiology / Q000401:mortality*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D005260:Female; D006678:HIV / Q000502:physiology*; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000276:immunology / Q000401:mortality*; D006801:Humans; D008297:Male; D019562:Viral Load