Impaired Hematologic Status in Relation to Clinical Outcomes among HIV-Infected Adults from Uganda: A Prospective Cohort Study.
Impaired Hematologic Status in Relation to Clinical Outcomes among HIV-Infected Adults from Uganda: A Prospective Cohort Study.
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DOI：
10.3390/nu10040475
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发表时间：
2018-04-12
期刊：
影响因子：
5.9
通讯作者：
Fawzi WW
中科院分区：
文献类型：
--
作者：
Ezeamama AE;Guwatudde D;Sikorskii A;Kabagambe EK;Spelts R;Vahey G;Fenton JI;Fawzi WW
研究了398名接受抗逆转录病毒治疗的艾滋病毒/艾滋病（PLWHA）成年患者的血液学状况受损（IHS）作为免疫功能的决定因素，其定义为分化簇4 (CD4) t辅助细胞计数、生活质量（QOL）体重和18个月以上住院/死亡率。IHS被定义为基线贫血（血红蛋白：女性<12 g/dL，男性<13 g/dL），时间更新贫血或基线铁蛋白水平低（<30 μg/L）或高（男性>200 μg/L，女性>150 μg/L）。从入组开始计算到住院/死亡或研究结束（如果没有事件）的月数。多变量线性混合模型量化了IHS与CD4细胞计数、体重增加和生活质量变化之间的关系。Cox比例风险模型计算了ihs相关的住院/死亡时间差异的风险比（HR）和相应的95%置信区间（CI）。基线时贫血患病率为48.7% (n = 194)，铁蛋白水平高和铁蛋白水平低分别为40.5% （n = 161）和17% （n = 68）。大多数患者（63.4%,n = 123）在随访期间仍然贫血。合并IHS的PLWHA患者体重增加（铁蛋白-时间相互作用，p < 0.01）和生活质量（贫血-时间相互作用，p = 0.05；铁蛋白-时间相互作用，p = 0.01）低于未合并IHS的PLWHA患者。与无贫血/正常铁蛋白相比，PLWHA患者合并贫血（HR = 2.0; 95% CI: 1.2-3.6）、低铁蛋白或高铁蛋白（HR: 1.8-1.9, 95% CI: 0.9-4.1）和新发/持续性/进行性贫血（HR: 2.3-6.7, 95% CI: 1.0-12.7）的住院/死亡风险升高。在PLWHA中，IHS预测生活质量下降、体重增加低和住院/死亡风险高。在接受长期高效抗逆转录病毒治疗（HAART）的艾滋病感染者中，有必要采取干预措施减轻持续性IHS，以改善健康结果。
Impaired hematologic status (IHS) was investigated as a determinant of immune function defined as cluster of differentiation 4 (CD4) T-helper cell count, quality of life (QOL) weight and hospitalization/mortality over 18-months among 398 adult persons living with HIV/AIDS (PLWHA) on anti-retroviral therapy. IHS was defined as having anemia at baseline (Hemoglobin: <12 g/dL for women and <13 g/dL for men), time-updated anemia or having low (<30 μg/L) or high (>200 μg/L for men and >150 μg/L for women) ferritin levels at baseline. Months-to-hospitalization/death or study-end (if no event) was calculated from enrollment. Multivariable linear-mixed models quantified associations between IHS and changes in CD4 cell-count, weight gain and QOL. Cox proportional hazards models calculated hazard ratios (HR) and corresponding 95% confidence intervals (CI) for IHS-related differences in time-to-hospitalization/death. The prevalences of anemia and high and low ferritin levels at baseline were 48.7% (n = 194), 40.5% (n = 161) and 17% (n = 68), respectively. Most patients (63.4%, n = 123) remained anemic during follow-up. Weight gained (ferritin-time interaction, p < 0.01) and QOL (anemia-time interaction, p = 0.05; ferritin-time interaction, p = 0.01) were lower for PLWHA with versus without IHS. Relative to anemia-free/normal ferritin, the risk of hospitalization/death was elevated for PLWHA with anemia (HR = 2.0; 95% CI: 1.2–3.6), low or high ferritin (HR: 1.8–1.9, 95% CI: 0.9–4.1) and those that developed new/persistent/progressive anemia (HR: 2.3–6.7, 95% CI: 1.0–12.7). Among PLWHA, IHS predicted deficits in QOL, low weight gain and a high risk of hospitalization/death. Intervention to mitigate persistent IHS may be warranted among PLWHA on long-term highly active antiretroviral therapy (HAART) to improve health outcomes.
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影响因子：
3.7
作者：
Kerkhoff AD;Wood R;Cobelens FG;Gupta-Wright A;Bekker LG;Lawn SD
通讯作者：
Lawn SD
影响因子：
4.2
作者：
Erhardt, JG;Estes, JE;Craft, NE
通讯作者：
Craft, NE
DOI：
10.1177/2325957413488195
发表时间：
2015-03-01
影响因子：
--
作者：
Makubi, Abel;Okuma, James;Fawzi, Wafaie
通讯作者：
Fawzi, Wafaie
影响因子：
1.4
作者：
Abrams, DI;Steinhart, C;Frascino, R
通讯作者：
Frascino, R
影响因子：
1.4
作者：
Al-Jafar, Hassan A
通讯作者：
Al-Jafar, Hassan A