title: Short-term risk of anaemia following initiation of combination antiretroviral treatment in HIV-infected patients in countries in sub-Saharan Africa, Asia-Pacific, and central and South America.
abstract: BACKGROUND
  The objective was to examine the short-term risk and predictors of anaemia following initiation of combination antiretroviral therapy (cART) in HIV-infected patients from the Western Africa, Eastern Africa, Southern Africa, Central Africa, Asian-Pacific, and Caribbean and Central and South America regions of the International Epidemiologic Databases to Evaluate AIDS (IeDEA) collaboration.
  
  
  METHODS
  Anaemia was defined as haemoglobin of < 10 g/dL. Patients were included if they started cART with three or more drugs, had prior haemoglobin of > = 10 g/dL, and had one or more follow-up haemoglobin tests. Factors associated with anaemia up to 12 months were examined using Cox proportional hazards models and stratified by IeDEA region.
  
  
  RESULTS
  Between 1998 and 2008, 19,947 patients initiated cART with baseline and follow-up haemoglobin tests (7358, 7289, 2853, 471, 1550 and 426 in the Western Africa, Eastern Africa, Southern Africa, Central Africa, Asian-Pacific, and Caribbean and Central and South America regions, respectively). At initiation, anaemia was found in 45% of Western Africa patients, 29% of Eastern Africa patients, 21% of Southern Africa patients, 36% of Central Africa patients, 15% of patients in Asian-Pacific and 14% of patients in Caribbean and Central and South America. Among patients with haemoglobin of > = 10 g/dL at baseline (13,445), the risks of anaemia were 18.2, 6.6, 9.7, 22.9, 11.8 and 19.5 per 100 person-years in the Western Africa, Eastern Africa, Southern Africa, Central Africa, Asian, and Caribbean and Central and South America regions, respectively. Factors associated with anaemia were female sex, low baseline haemoglobin level, low baseline CD4 count, more advanced disease stage, and initial cART containing zidovudine.
  
  
  CONCLUSIONS
  In data from 34 cohorts of HIV-infected patients from sub-Saharan Africa, Central and South America, and Asia, the risk of anaemia within 12 months of initiating cART was moderate. Routine haemoglobin monitoring was recommended in patients at risk of developing anaemia following cART initiation.
authors.affiliation: The Kirby Institute, The University of New South Wales, Sydney, NSW, Australia.
authors.forename: Jialun
authors.initials: J
authors.lastname: Zhou
authors.forename: Antoine
authors.initials: A
authors.lastname: Jaquet
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Bissagnene
authors.forename: Beverly
authors.initials: B
authors.lastname: Musick
authors.forename: Kara
authors.initials: K
authors.lastname: Wools-Kaloustian
authors.forename: Nicola
authors.initials: N
authors.lastname: Maxwell
authors.forename: Andrew
authors.initials: A
authors.lastname: Boulle
authors.forename: Firas
authors.initials: F
authors.lastname: Wehbe
authors.forename: Daniel
authors.initials: D
authors.lastname: Masys
authors.forename: Jeniffer
authors.initials: J
authors.lastname: Iriondo-Perez
authors.forename: Jay
authors.initials: J
authors.lastname: Hemingway-Foday
authors.forename: Matthew
authors.initials: M
authors.lastname: Law
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D000740:Anemia / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010139:Pacific Islands / Q000453:epidemiology; D012307:Risk Factors; D013020:South America / Q000453:epidemiology; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D006454:Hemoglobins