期刊
JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
卷 37, 期 2, 页码 1245-1252出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/01.qai.0000134759.01684.27
关键词
HIV; AIDS; anemia; women; survival
资金
- NIAID NIH HHS [U01-AI-34989, U01-AI-31834, U01-AI-35004, N01-AI-35161, U01-AI-34994, U01-AI-42590] Funding Source: Medline
- NICHD NIH HHS [U01-HD-32632] Funding Source: Medline
Background: Anemia is common in HIV-infected individuals and may be associated with decreased survival. Objective: To ascertain the impact of highly active antiretroviral therapy (HAART) on anemia and the relationship between anemia and overall survival in HIV-infected women. Methods: A prospective multicenter study of HIV-1 infection in women. Visits occurred every 6 months, including a standardized history, physical examination, and comprehensive laboratory evaluation. The setting was a university-affiliated clinic at 6 sites in the United States. Participants were 2056 HIV-infected women from the Women's Interagency HIV Study (WIHS). The Outcome measure was anemia, defined as hemoglobin (Hb) < 12 g/dL. Survival analysis was based on overall mortality during the follow-up period. Results: Among HIV-infected women who were notaneirtic at baseline, 47% became anemic by 3.5 years of follow-up. On multivariate analysis, the use of HAART was associated with resolution of anemia even when used for only 6 months (odds ratio [OR] = 1.45; P < 0.05). In the multivariate model, a CD4 cell count <200 cells/muL (OR = 0.56; P < 0.00 1); HIV-1 RNA level greater than or equal to 50,000 copies/mL (OR = 0.65; P < 0.001), and mean corpuscular volume (MCV) value <80 fL (OR 0.40; P < 0.001) were also associated with an inability to Correct anemia. Similarly, use of HAART for 12 months or more was associated with a protective effect against development of anemia (OR = 0.71; P < 0.001). Among HIV-infected women, anemia was independently associated with decreased survival (hazard ratio [HR] = 2.58; P < 0.001). Other factors associated with decreased Survival included a CD4 cell Count <200 cells/pL (HR = 5.83; P < 0.001), HIV-1 RNA level greater than or equal to 50,000 copies/ml- (HR = 2.12; P < 0.001), and clinical diagnosis of AIDS (HR = 2.83-1 P < 0.001). Conclusions: Anemia is an independent risk factor for decreased Survival among HIV-infected women. HAART therapy for as little as 6 months is associated with resolution of anernia.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据