Prevalence and outcomes of anemia in individuals with human immunodeficiency virus: a systematic review of the literature.
In patients with human immunodeficiency virus (HIV), anemia is a commonly encountered hematologic abnormality that has a significant impact on clinical outcomes and quality of life (QOL). This review describes the prevalence of anemia in several populations of patients with HIV and the effects of anemia on survival, morbidity, disease progression, transfusion requirements, and QOL. The prevalence of anemia in HIV disease varies considerably, ranging from 1.3% to 95%: it depends on several factors, including the stage of HIV disease, sex, age, pregnancy status, and injection-drug use as well as the definition of anemia used. In general, as HIV disease progresses, the prevalence and severity of anemia increase. Anemia is also more prevalent in HIV-positive women, children, and injection-drug users than in HIV-negative women, children, and injection-drug users. Anemia has been shown to be a statistically significant predictor of progression to the acquired immunodeficiency syndrome and is independently associated with an increased risk of death in patients with HIV. Treatment of anemia with epoetin-alpha has resulted in significantly fewer patients requiring transfusion as well as decreases in the mean number of units of blood transfused. Resolution of HIV-related anemia has been shown to improve QOL, physical functioning, energy, and fatigue in individuals with HIV. More recently, the use of highly active antiretroviral therapy has also been associated with a significant increase in hemoglobin concentrations and a decrease in the prevalence of anemia.
Belperio
Pamela S
PS
Infectious Diseases Section, Department of Research and Development, the Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA.
Rhew
David C
DC
D000203:Activities of Daily Living; D000328:Adult; D000740:Anemia / Q000453:epidemiology / Q000523:psychology / Q000628:therapy / Q000821:virology; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001803:Blood Transfusion; D018791:CD4 Lymphocyte Count; D002648:Child; D015897:Comorbidity; D018450:Disease Progression; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000627:therapeutic use; D005221:Fatigue / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D006397:Hematinics / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D015995:Prevalence; D011788:Quality of Life; D011994:Recombinant Proteins; D012720:Severity of Illness Index; D015819:Substance Abuse, Intravenous / Q000150:complications; D016019:Survival Analysis
D019380:Anti-HIV Agents; D006397:Hematinics; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa