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Anemia is independently associated with mortality in people living with human immunodeficiency virus/acquired immune deficiency syndrome: A propensity score matching-based retrospective cohort study in China

Although previous studies have suggested that hemoglobin is related to the health status of people living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) (PLWHA), the role of anemia in mortality remains unclear. This study aimed to comprehensively quantify the effect...

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Autores principales: Jin, Meihua, Wang, Yanan, Li, Jing, Wu, Zhenqian, Liu, Xiaoqi, Wang, Hui, Chen, Yuxin, Wang, Ziyi, Tong, Zhaowei, Li, Xiaofeng, Ren, Feilin, Zhu, Xiaojuan, Yang, Zhongrong, Mao, Guangyun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9975156/
https://www.ncbi.nlm.nih.gov/pubmed/36873867
http://dx.doi.org/10.3389/fmed.2023.1055115
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author Jin, Meihua
Wang, Yanan
Li, Jing
Wu, Zhenqian
Liu, Xiaoqi
Wang, Hui
Chen, Yuxin
Wang, Ziyi
Tong, Zhaowei
Li, Xiaofeng
Ren, Feilin
Zhu, Xiaojuan
Yang, Zhongrong
Mao, Guangyun
author_facet Jin, Meihua
Wang, Yanan
Li, Jing
Wu, Zhenqian
Liu, Xiaoqi
Wang, Hui
Chen, Yuxin
Wang, Ziyi
Tong, Zhaowei
Li, Xiaofeng
Ren, Feilin
Zhu, Xiaojuan
Yang, Zhongrong
Mao, Guangyun
author_sort Jin, Meihua
collection PubMed
description Although previous studies have suggested that hemoglobin is related to the health status of people living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) (PLWHA), the role of anemia in mortality remains unclear. This study aimed to comprehensively quantify the effect of anemia on the mortality risk of PLWHA. In this retrospective cohort study, we thoroughly estimated the effect of anemia on PLWHA mortality, using data collected from January 2005 to June 2022 in the Huzhou area, in 450 subjects extracted from the database of the China Disease Prevention and Control Information System and matched them using a propensity score matching approach to balance potential confounding bias. The potential exposure–response relationship between anemia, hemoglobin concentration, and the mortality of PLWHA was also carefully estimated. A series of subgroup analyses, including interaction analysis, was further conducted to validate the robustness of the effect of anemia on PLWHA death risk. Anemia was significantly associated with an elevated death risk in PLWHA, with an increase of 74% (adjusted hazard ratio [AHR]: 1.74; 95% confidence interval [CI]: 1.03–2.93; p = 0.038) in those with anemia after adjusting for potential confounders. PLWHA with moderate or severe anemia had a higher risk of death, with an 86% increase (AHR = 1.86; 95% CI: 1.01–3.42; p = 0.045). Meanwhile, the AHR tended to increase by 85% on average (AHR = 1.85, 95% CI: 1.37–2.50; p < 0.001) with a per standard deviation (SD) decrease in plasma hemoglobin. Consistent relationships between plasma hemoglobin and the risk of death were further observed in the results from multiple quantile regression models, restricted cubic spline regression models, and a series of subgroup analyses. Anemia is an independent risk factor for HIV/AIDS-related mortality. Our findings may provide new insights into the relevance of PLWHA administration to public health policy, which demonstrate that this low-cost and routinely measured marker (hemoglobin) can be a marker of poor prognosis even before the start of HAART.
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spelling pubmed-99751562023-03-02 Anemia is independently associated with mortality in people living with human immunodeficiency virus/acquired immune deficiency syndrome: A propensity score matching-based retrospective cohort study in China Jin, Meihua Wang, Yanan Li, Jing Wu, Zhenqian Liu, Xiaoqi Wang, Hui Chen, Yuxin Wang, Ziyi Tong, Zhaowei Li, Xiaofeng Ren, Feilin Zhu, Xiaojuan Yang, Zhongrong Mao, Guangyun Front Med (Lausanne) Medicine Although previous studies have suggested that hemoglobin is related to the health status of people living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) (PLWHA), the role of anemia in mortality remains unclear. This study aimed to comprehensively quantify the effect of anemia on the mortality risk of PLWHA. In this retrospective cohort study, we thoroughly estimated the effect of anemia on PLWHA mortality, using data collected from January 2005 to June 2022 in the Huzhou area, in 450 subjects extracted from the database of the China Disease Prevention and Control Information System and matched them using a propensity score matching approach to balance potential confounding bias. The potential exposure–response relationship between anemia, hemoglobin concentration, and the mortality of PLWHA was also carefully estimated. A series of subgroup analyses, including interaction analysis, was further conducted to validate the robustness of the effect of anemia on PLWHA death risk. Anemia was significantly associated with an elevated death risk in PLWHA, with an increase of 74% (adjusted hazard ratio [AHR]: 1.74; 95% confidence interval [CI]: 1.03–2.93; p = 0.038) in those with anemia after adjusting for potential confounders. PLWHA with moderate or severe anemia had a higher risk of death, with an 86% increase (AHR = 1.86; 95% CI: 1.01–3.42; p = 0.045). Meanwhile, the AHR tended to increase by 85% on average (AHR = 1.85, 95% CI: 1.37–2.50; p < 0.001) with a per standard deviation (SD) decrease in plasma hemoglobin. Consistent relationships between plasma hemoglobin and the risk of death were further observed in the results from multiple quantile regression models, restricted cubic spline regression models, and a series of subgroup analyses. Anemia is an independent risk factor for HIV/AIDS-related mortality. Our findings may provide new insights into the relevance of PLWHA administration to public health policy, which demonstrate that this low-cost and routinely measured marker (hemoglobin) can be a marker of poor prognosis even before the start of HAART. Frontiers Media S.A. 2023-02-15 /pmc/articles/PMC9975156/ /pubmed/36873867 http://dx.doi.org/10.3389/fmed.2023.1055115 Text en Copyright © 2023 Jin, Wang, Li, Wu, Liu, Wang, Chen, Wang, Tong, Li, Ren, Zhu, Yang and Mao. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Jin, Meihua
Wang, Yanan
Li, Jing
Wu, Zhenqian
Liu, Xiaoqi
Wang, Hui
Chen, Yuxin
Wang, Ziyi
Tong, Zhaowei
Li, Xiaofeng
Ren, Feilin
Zhu, Xiaojuan
Yang, Zhongrong
Mao, Guangyun
Anemia is independently associated with mortality in people living with human immunodeficiency virus/acquired immune deficiency syndrome: A propensity score matching-based retrospective cohort study in China
title Anemia is independently associated with mortality in people living with human immunodeficiency virus/acquired immune deficiency syndrome: A propensity score matching-based retrospective cohort study in China
title_full Anemia is independently associated with mortality in people living with human immunodeficiency virus/acquired immune deficiency syndrome: A propensity score matching-based retrospective cohort study in China
title_fullStr Anemia is independently associated with mortality in people living with human immunodeficiency virus/acquired immune deficiency syndrome: A propensity score matching-based retrospective cohort study in China
title_full_unstemmed Anemia is independently associated with mortality in people living with human immunodeficiency virus/acquired immune deficiency syndrome: A propensity score matching-based retrospective cohort study in China
title_short Anemia is independently associated with mortality in people living with human immunodeficiency virus/acquired immune deficiency syndrome: A propensity score matching-based retrospective cohort study in China
title_sort anemia is independently associated with mortality in people living with human immunodeficiency virus/acquired immune deficiency syndrome: a propensity score matching-based retrospective cohort study in china
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9975156/
https://www.ncbi.nlm.nih.gov/pubmed/36873867
http://dx.doi.org/10.3389/fmed.2023.1055115
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