Anemia is an independent predictor of mortality and immunologic progression of disease among women with HIV in Tanzania
Anemia is an independent predictor of mortality and immunologic progression of disease among women with HIV in Tanzania
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DOI：
10.1097/01.qai.0000166374.16222.a2
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发表时间：
2005-10-01
影响因子：
3.6
通讯作者：
Fawzi, WW
中科院分区：
文献类型：
--
作者：
O'Brien, ME;Kupka, R;Fawzi, WW
目的：研究坦桑尼亚达累斯萨拉姆的一组 HIV 感染妇女中贫血与死亡率和疾病进展的关系。方法：1995 年至 2003 年期间，参加一项维生素补充剂临床试验的 1078 名 HIV 阳性孕妇的全因死亡时间、艾滋病相关死亡以及 CD4 细胞计数下降 50%。结果：调整后的模型显示，贫血与全因死亡风险增加相关（相对危险 [RH]：中度贫血为 2.06，95% CI：1.52 至 2.79，重度贫血为 RH：3.19，95% CI：2.23 至 4.56）和艾滋病相关死亡率（中度贫血为 RH：2.21，95% CI：1.53 至 3.19，RH：3.47、95%） Cl：严重贫血时为 2.25 至 5.33），与 CD4 细胞计数、世界卫生组织临床分期、年龄、妊娠、维生素补充和体重指数无关。贫血还与 CD4 计数更快下降有关，以 CD4 细胞计数从基线下降 50% 的时间来衡量。提示缺铁的红细胞特征也与全因死亡和艾滋病相关死亡以及 CD4 细胞计数下降 50% 相关。结论：贫血是该队列中死亡率和疾病进展的独立预测因素。贫血筛查以及预防和治疗工作应纳入艾滋病毒护理举措中，特别是针对妇女的举措。
Objective: To examine the association of anemia with mortality and disease progression among a cohort of women with HIV in Dar es Salaam, Tanzania.Methods: Time to all-cause death, AIDS-related death, and a 50% decrease in CD4 cell count among 1078 HIV-positive pregnant women enrolled in a clinical trial of vitamin supplementation from 1995-2003.Results: Adjusted models showed that anemia was associated with an increased risk of all-cause mortality (relative hazard [RH]: 2.06, 95% CI: 1.52 to 2.79 for moderate anemia and RH: 3.19, 95% CI: 2.23 to 4.56 for severe anemia) and AIDS-related mortality (RH: 2.21, 95% CI: 1.53 to 3.19 for moderate anemia and RH: 3.47, 95% Cl: 2.25 to 5.33 for severe anemia), independent of CD4 cell count, World Health Organization clinical stage, age, pregnancy, vitamin supplementation, and body mass index. Anemia was also associated with a more rapid decline in CD4 counts, measured as time to a 50% drop in CD4 cell count from baseline. Erythrocyte characteristics suggestive of iron deficiency were also associated with all-cause and AIDS-related death and a 50% decline in CD4 cell count.Conclusions: Anemia is an independent predictor of mortality and disease progression in this cohort. Screening for anemia, coupled with prevention and treatment efforts, should be included in HIV care initiatives, particularly those that target women.