Development of severe anemia and changes in hemoglobin in a cohort of HIV-infected Ugandan adults receiving zidovudine-, stavudine-, and tenofovir-containing antiretroviral regimens

Parkes-Ratanshi, R., Katende, D., Levin, J., Wakeham, K., Heiner, G., Kamali, A. and Lalloo, D. G. (2015) Development of severe anemia and changes in hemoglobin in a cohort of HIV-infected Ugandan adults receiving zidovudine-, stavudine-, and tenofovir-containing antiretroviral regimens. Journal of the International Association of Providers of AIDS Care, 14(5), pp. 455-462. (doi:10.1177/2325957414557264) (PMID:25425638)

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Abstract

Introduction: Anemia is a common problem in HIV in sub-Saharan Africa. We describe the contribution of antiretroviral therapy (ART) regimen to the incidence of anemia and changes in hemoglobin (Hb) in HIV-infected patients in Uganda. Methods: This study was nested in a prevention of cryptococcal disease trial (CRYPTOPRO; ISCRTN7648152). Patients received 3 different backbones of nucleoside reverse transcriptase inhibitor in a nonrandomized manner. Results: Of the 852 patients (161 on zidovudine [ZDV], 628 on stavudine [d4T], and 63 on tenofovir [TDF]; all received lamuvidine), the risk of developing grade 4 anemia was higher (adjusted hazard ratio 2.7) for those receiving ZDV than those receiving d4T. Those receivingd4T had a higher average increase in Hb than those receiving ZDV (P = .024) or TDF (P = .014). Conclusion: In this observational study, ZDV was associated with severe anemia compared to d4T or TDF; those receiving ZDV and TDF had smaller increases in Hb after ART initiation. We encourage publication of data on cohorts using TDF from Africa.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Wakeham, Dr Katie
Authors: Parkes-Ratanshi, R., Katende, D., Levin, J., Wakeham, K., Heiner, G., Kamali, A., and Lalloo, D. G.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cancer Sciences
Journal Name:Journal of the International Association of Providers of AIDS Care
Publisher:SAGE Publications
ISSN:2325-9574
ISSN (Online):2325-9582

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