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Anemia risk factors among people living with HIV across the United States in the current treatment era: a clinical cohort study

BACKGROUND: Anemia is common among people living with HIV infection (PLWH) and is associated with adverse health outcomes. Information on risk factors for anemia incidence in the current antiretroviral therapy (ART) era is lacking. METHODS: Within a prospective clinical cohort of adult PLWH receivin...

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Autores principales: Harding, B. N., Whitney, B. M., Nance, R. M., Ruderman, S. A., Crane, H. M., Burkholder, G., Moore, R. D., Mathews, W. C., Eron, J. J., Hunt, P. W., Volberding, P., Rodriguez, B., Mayer, K. H., Saag, M. S., Kitahata, M. M., Heckbert, S. R., Delaney, J. A. C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085166/
https://www.ncbi.nlm.nih.gov/pubmed/32197585
http://dx.doi.org/10.1186/s12879-020-04958-z
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author Harding, B. N.
Whitney, B. M.
Nance, R. M.
Ruderman, S. A.
Crane, H. M.
Burkholder, G.
Moore, R. D.
Mathews, W. C.
Eron, J. J.
Hunt, P. W.
Volberding, P.
Rodriguez, B.
Mayer, K. H.
Saag, M. S.
Kitahata, M. M.
Heckbert, S. R.
Delaney, J. A. C.
author_facet Harding, B. N.
Whitney, B. M.
Nance, R. M.
Ruderman, S. A.
Crane, H. M.
Burkholder, G.
Moore, R. D.
Mathews, W. C.
Eron, J. J.
Hunt, P. W.
Volberding, P.
Rodriguez, B.
Mayer, K. H.
Saag, M. S.
Kitahata, M. M.
Heckbert, S. R.
Delaney, J. A. C.
author_sort Harding, B. N.
collection PubMed
description BACKGROUND: Anemia is common among people living with HIV infection (PLWH) and is associated with adverse health outcomes. Information on risk factors for anemia incidence in the current antiretroviral therapy (ART) era is lacking. METHODS: Within a prospective clinical cohort of adult PLWH receiving care at eight sites across the United States between 1/2010–3/2018, Cox proportional hazards regression analyses were conducted among a) PLWH free of anemia at baseline and b) PLWH free of severe anemia at baseline to determine associations between time-updated patient characteristics and development of anemia (hemoglobin < 10 g/dL), or severe anemia (hemoglobin < 7.5 g/dL). Linear mixed effects models were used to examine relationships between patient characteristics and hemoglobin levels during follow-up. Hemoglobin levels were ascertained using laboratory data from routine clinical care. Potential risk factors included: age, sex, race/ethnicity, body mass index, smoking status, hazardous alcohol use, illicit drug use, hepatitis C virus (HCV) coinfection, estimated glomerular filtration rate (eGFR), CD4 cell count, viral load, ART use and time in care at CNICS site. RESULTS: This retrospective cohort study included 15,126 PLWH. During a median follow-up of 6.6 (interquartile range [IQR] 4.3–7.6) years, 1086 participants developed anemia and 465 participants developed severe anemia. Factors that were associated with incident anemia included: older age, female sex, black race, HCV coinfection, lower CD4 cell counts, VL ≥400 copies/ml and lower eGFR. CONCLUSION: Because anemia is a treatable condition associated with increased morbidity and mortality among PLWH, hemoglobin levels should be monitored routinely, especially among PLWH who have one or more risk factors for anemia.
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spelling pubmed-70851662020-03-23 Anemia risk factors among people living with HIV across the United States in the current treatment era: a clinical cohort study Harding, B. N. Whitney, B. M. Nance, R. M. Ruderman, S. A. Crane, H. M. Burkholder, G. Moore, R. D. Mathews, W. C. Eron, J. J. Hunt, P. W. Volberding, P. Rodriguez, B. Mayer, K. H. Saag, M. S. Kitahata, M. M. Heckbert, S. R. Delaney, J. A. C. BMC Infect Dis Research Article BACKGROUND: Anemia is common among people living with HIV infection (PLWH) and is associated with adverse health outcomes. Information on risk factors for anemia incidence in the current antiretroviral therapy (ART) era is lacking. METHODS: Within a prospective clinical cohort of adult PLWH receiving care at eight sites across the United States between 1/2010–3/2018, Cox proportional hazards regression analyses were conducted among a) PLWH free of anemia at baseline and b) PLWH free of severe anemia at baseline to determine associations between time-updated patient characteristics and development of anemia (hemoglobin < 10 g/dL), or severe anemia (hemoglobin < 7.5 g/dL). Linear mixed effects models were used to examine relationships between patient characteristics and hemoglobin levels during follow-up. Hemoglobin levels were ascertained using laboratory data from routine clinical care. Potential risk factors included: age, sex, race/ethnicity, body mass index, smoking status, hazardous alcohol use, illicit drug use, hepatitis C virus (HCV) coinfection, estimated glomerular filtration rate (eGFR), CD4 cell count, viral load, ART use and time in care at CNICS site. RESULTS: This retrospective cohort study included 15,126 PLWH. During a median follow-up of 6.6 (interquartile range [IQR] 4.3–7.6) years, 1086 participants developed anemia and 465 participants developed severe anemia. Factors that were associated with incident anemia included: older age, female sex, black race, HCV coinfection, lower CD4 cell counts, VL ≥400 copies/ml and lower eGFR. CONCLUSION: Because anemia is a treatable condition associated with increased morbidity and mortality among PLWH, hemoglobin levels should be monitored routinely, especially among PLWH who have one or more risk factors for anemia. BioMed Central 2020-03-20 /pmc/articles/PMC7085166/ /pubmed/32197585 http://dx.doi.org/10.1186/s12879-020-04958-z Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Harding, B. N.
Whitney, B. M.
Nance, R. M.
Ruderman, S. A.
Crane, H. M.
Burkholder, G.
Moore, R. D.
Mathews, W. C.
Eron, J. J.
Hunt, P. W.
Volberding, P.
Rodriguez, B.
Mayer, K. H.
Saag, M. S.
Kitahata, M. M.
Heckbert, S. R.
Delaney, J. A. C.
Anemia risk factors among people living with HIV across the United States in the current treatment era: a clinical cohort study
title Anemia risk factors among people living with HIV across the United States in the current treatment era: a clinical cohort study
title_full Anemia risk factors among people living with HIV across the United States in the current treatment era: a clinical cohort study
title_fullStr Anemia risk factors among people living with HIV across the United States in the current treatment era: a clinical cohort study
title_full_unstemmed Anemia risk factors among people living with HIV across the United States in the current treatment era: a clinical cohort study
title_short Anemia risk factors among people living with HIV across the United States in the current treatment era: a clinical cohort study
title_sort anemia risk factors among people living with hiv across the united states in the current treatment era: a clinical cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085166/
https://www.ncbi.nlm.nih.gov/pubmed/32197585
http://dx.doi.org/10.1186/s12879-020-04958-z
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