Improvement of Anemia Among HIV-Infected Injection Drug Users Receiving Highly Active Antiretroviral Therapy

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Abstract
Summary:Although anemia is common during HIV infection, it is unclear whether potent antiretroviral therapy would improve or worsen anemia. We conducted a study to examine the impact of highly active antiretroviral therapy (HAART) on anemia in a cohort of HIV-positive injection drug users (IDUs) in Baltimore, Maryland. At baseline, the overall prevalence of anemia was 40%. During mean follow-up of one year, among 102 subjects who received HAART, there was a mean increase in hemoglobin of 3.6 ± 1.7 g/L (p = .04) and a mean decrease in log10 plasma HIV load of 0.78 ± 0.17 copies/ml (p <.0001). Among 103 control subjects who were not receiving antiretroviral medications, there was a mean decrease in hemoglobin of 4.2 ±1.1 g/L (p <.0003) and mean increase in log10 plasma HIV load of 0.25 ± 0.06 copies/ml (p <.0002). Multivariate analysis using mixed linear models showed that HAART was associated with an increase of hemoglobin of 0.223 g/L per month (p < .0001) after adjusting for body mass index, opportunistic infections, and gender. HAART was associated with an improvement in anemia, and potential mechanisms that may be involved include a reduction in opportunistic infections and the anemia of chronic disease and an improvement in nutritional status. Address correspondence and reprint requests to Richard D. Semba, 550 N. Broadway, Suite 700, Baltimore, MD 21205, U.S.A.; e-mail: [email protected] Manuscript received October 14, 2000; accepted November 20, 2000. © 2001 Lippincott Williams & Wilkins, Inc.