Resolution of anaemia in a cohort of HIV-infected patients with a high prevalence and incidence of tuberculosis receiving antiretroviral therapy in South Africa

 

Show simple item record

dc.contributor.author Kerkhoff, Andrew en_ZA
dc.contributor.author Wood, Robin en_ZA
dc.contributor.author Cobelens, Frank en_ZA
dc.contributor.author Gupta-Wright, Ankur en_ZA
dc.contributor.author Bekker, Linda-Gail en_ZA
dc.contributor.author Lawn, Stephen en_ZA
dc.date.accessioned 2015-11-27T09:28:21Z
dc.date.available 2015-11-27T09:28:21Z
dc.date.issued 2014 en_ZA
dc.identifier.citation Kerkhoff, A. D., Wood, R., Cobelens, F. G., Gupta-Wright, A., Bekker, L. G., & Lawn, S. D. (2014). Resolution of anaemia in a cohort of HIV-infected patients with a high prevalence and incidence of tuberculosis receiving antiretroviral therapy in South Africa. BMC infectious diseases, 14(1), 3860. en_ZA
dc.identifier.uri http://hdl.handle.net/11427/15374
dc.identifier.uri http://dx.doi.org/10.1186/s12879-014-0702-1
dc.description.abstract BACKGROUND: Anaemia is frequently associated with both HIV-infection and HIV-related tuberculosis (TB) in antiretroviral therapy (ART)-naive patients in sub-Saharan Africa and is strongly associated with poor prognosis. However, the effect of ART on the resolution of anaemia in patient cohorts with a high prevalence and incidence of tuberculosis is incompletely defined and the impact of TB episodes on haemoglobin recovery has not previously been reported. We therefore examined these issues using data from a well-characterised cohort of patients initiating ART in South Africa. METHODS: Prospectively collected clinical and haematological data were retrospectively analysed from patients receiving ART in a South African township ART service. TB diagnoses and time-updated haemoglobin concentrations, CD4 counts and HIV viral loads were recorded. Anaemia severity was classified according to WHO criteria. Multivariable logistic regression analysis was used to determine factors independently associated with anaemia after 12months of ART. RESULTS: Of 1,140 patients with baseline haemoglobin levels, 814 were alive in care and had repeat values available after 12months of ART. The majority of patients were female (73%), the median CD4 count was 104 cells/uL and 30.5% had a TB diagnosis in the first year of ART. At baseline, anaemia (any severity) was present in 574 (70.5%) patients and was moderate/severe in 346 (42.5%). After 12months of ART, 218 (26.8%) patients had anaemia of any severity and just 67 (8.2%) patients had moderate/severe anaemia. Independent predictors of anaemia after 12months of ART included greater severity of anaemia at baseline, time-updated erythrocyte microcytosis and receipt of an AZT-containing regimen. In contrast, prevalent and/or incident TB, gender and baseline and time-updated CD4 cell count and viral load measurements were not independent predictors. CONCLUSIONS: Although anaemia was very common among ART-naive patients, the anaemia resolved during the first year of ART in a large majority of patients regardless of TB status without routine use of additional interventions. However, approximately one-quarter of patients remained anaemic after one year of ART and may require additional investigations and/or interventions. en_ZA
dc.language.iso eng en_ZA
dc.publisher BioMed Central Ltd en_ZA
dc.rights This is an Open Access article distributed under the terms of the Creative Commons Attribution License en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/4.0. en_ZA
dc.source BMC Infectious Diseases en_ZA
dc.source.uri http://www.biomedcentral.com/bmcinfectdis/ en_ZA
dc.subject.other HIV en_ZA
dc.subject.other Tuberculosis en_ZA
dc.subject.other Africa en_ZA
dc.subject.other Anaemia en_ZA
dc.subject.other Haemoglobin en_ZA
dc.subject.other Antiretroviral en_ZA
dc.title Resolution of anaemia in a cohort of HIV-infected patients with a high prevalence and incidence of tuberculosis receiving antiretroviral therapy in South Africa en_ZA
dc.type Journal Article en_ZA
dc.rights.holder 2014 Kerkhoff et al.; licensee BioMed Central. en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Desmond Tutu HIV Centre en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Kerkhoff, A., Wood, R., Cobelens, F., Gupta-Wright, A., Bekker, L., & Lawn, S. (2014). Resolution of anaemia in a cohort of HIV-infected patients with a high prevalence and incidence of tuberculosis receiving antiretroviral therapy in South Africa. <i>BMC Infectious Diseases</i>, http://hdl.handle.net/11427/15374 en_ZA
dc.identifier.chicagocitation Kerkhoff, Andrew, Robin Wood, Frank Cobelens, Ankur Gupta-Wright, Linda-Gail Bekker, and Stephen Lawn "Resolution of anaemia in a cohort of HIV-infected patients with a high prevalence and incidence of tuberculosis receiving antiretroviral therapy in South Africa." <i>BMC Infectious Diseases</i> (2014) http://hdl.handle.net/11427/15374 en_ZA
dc.identifier.vancouvercitation Kerkhoff A, Wood R, Cobelens F, Gupta-Wright A, Bekker L, Lawn S. Resolution of anaemia in a cohort of HIV-infected patients with a high prevalence and incidence of tuberculosis receiving antiretroviral therapy in South Africa. BMC Infectious Diseases. 2014; http://hdl.handle.net/11427/15374. en_ZA
dc.identifier.ris TY - Journal Article AU - Kerkhoff, Andrew AU - Wood, Robin AU - Cobelens, Frank AU - Gupta-Wright, Ankur AU - Bekker, Linda-Gail AU - Lawn, Stephen AB - BACKGROUND: Anaemia is frequently associated with both HIV-infection and HIV-related tuberculosis (TB) in antiretroviral therapy (ART)-naive patients in sub-Saharan Africa and is strongly associated with poor prognosis. However, the effect of ART on the resolution of anaemia in patient cohorts with a high prevalence and incidence of tuberculosis is incompletely defined and the impact of TB episodes on haemoglobin recovery has not previously been reported. We therefore examined these issues using data from a well-characterised cohort of patients initiating ART in South Africa. METHODS: Prospectively collected clinical and haematological data were retrospectively analysed from patients receiving ART in a South African township ART service. TB diagnoses and time-updated haemoglobin concentrations, CD4 counts and HIV viral loads were recorded. Anaemia severity was classified according to WHO criteria. Multivariable logistic regression analysis was used to determine factors independently associated with anaemia after 12months of ART. RESULTS: Of 1,140 patients with baseline haemoglobin levels, 814 were alive in care and had repeat values available after 12months of ART. The majority of patients were female (73%), the median CD4 count was 104 cells/uL and 30.5% had a TB diagnosis in the first year of ART. At baseline, anaemia (any severity) was present in 574 (70.5%) patients and was moderate/severe in 346 (42.5%). After 12months of ART, 218 (26.8%) patients had anaemia of any severity and just 67 (8.2%) patients had moderate/severe anaemia. Independent predictors of anaemia after 12months of ART included greater severity of anaemia at baseline, time-updated erythrocyte microcytosis and receipt of an AZT-containing regimen. In contrast, prevalent and/or incident TB, gender and baseline and time-updated CD4 cell count and viral load measurements were not independent predictors. CONCLUSIONS: Although anaemia was very common among ART-naive patients, the anaemia resolved during the first year of ART in a large majority of patients regardless of TB status without routine use of additional interventions. However, approximately one-quarter of patients remained anaemic after one year of ART and may require additional investigations and/or interventions. DA - 2014 DB - OpenUCT DO - 10.1186/s12879-014-0702-1 DP - University of Cape Town J1 - BMC Infectious Diseases LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 T1 - Resolution of anaemia in a cohort of HIV-infected patients with a high prevalence and incidence of tuberculosis receiving antiretroviral therapy in South Africa TI - Resolution of anaemia in a cohort of HIV-infected patients with a high prevalence and incidence of tuberculosis receiving antiretroviral therapy in South Africa UR - http://hdl.handle.net/11427/15374 ER - en_ZA


Files in this item

This item appears in the following Collection(s)

Show simple item record

This is an Open Access article distributed under the terms of the Creative Commons Attribution License Except where otherwise noted, this item's license is described as This is an Open Access article distributed under the terms of the Creative Commons Attribution License