title: Magnitude and correlates of moderate to severe anemia among adult HIV patients receiving first line HAART in Northwestern Tanzania: a cross sectional clinic based study.
abstract: BACKGROUND
  Moderate to severe anemia is an important clinical problem in HIV patients on Highly Active Antiretroviral Therapy. The rate of progression and mortality in this sub group of patients is high compared to non anemic patients. In sub Saharan Africa with scale up of Anti retroviral therapy, the magnitude of this problem is not known especially in Tanzania. This study aimed at determining the magnitude and correlates of moderate to severe anemia in HIV patients receiving first line ART in northwestern Tanzania.
  
  
  METHODS
  This was a cross sectional clinic based study, involving adult HIV patients on first line Highly Active Antiretroviral Therapy at Bugando Medical Centre Care and Treatment Center. The patients' data were analyzed using STATA version 11 to determine the prevalence of moderate to severe anemia and risk factors that could predict occurrence of anemia.
  
  
  RESULTS
  In this study 346 patients on Highly Active Anti-Retroviral Therapy were enrolled, of whom 100(40.46%) had moderate to severe anemia. The odds of being anemic were strongly predicted by Zidovudine based regime, low baseline CD4 count (< 200 cells/μl) and HIV stage 3&4 at enrollment. Most of the anemic patients had mean corpuscular volume of >100 fl.
  
  
  CONCLUSIONS
  The prevalence of moderate to severe anemia is significantly high in this cohort of HIV-infected patients on first line Anti Retroviral Therapy and it is strongly predicted by Zidovudine based regime, low baseline CD4 and HIV stage 3 and 4. On clinical grounds this suggests that patients who are initiated on Zidovudine based regimen and those in advanced HIV at enrollment should have regular haemoglobin follow up to identify anemia at its earliest stage to improve the clinical outcome of these patients.
authors.affiliation: Department of Medicine, Weill Bugando School of Medicine, Mwanza, Tanzania.
authors.forename: Daniel Wilfred
authors.initials: DW
authors.lastname: Gunda
authors.affiliation: Department of Medicine, Weill Bugando School of Medicine, Mwanza, Tanzania.
authors.forename: Semvua Bukheti
authors.initials: SB
authors.lastname: Kilonzo
authors.affiliation: Department of Medicine, College of Health Sciences, University of Dodoma, Dodoma, Tanzania.
authors.forename: Bonaventura Cornel
authors.initials: BC
authors.lastname: Mpondo
mesh_terms: D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D000740:Anemia / Q000453:epidemiology*; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult; D015215:Zidovudine / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D019380:Anti-HIV Agents; D006454:Hemoglobins; D015215:Zidovudine
keywords: HIV/AIDS; Tanzania; anemia; antiretroviral therapy; risk factors