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Anemia in Human Immunodeficiency Virus–Infected and Uninfected Women in Rwanda

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  • Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, Belgium; Department of Medical Biology and Department of Internal Medicine, Faculty of Medicine, National University of Rwanda, Huye, Rwanda

To determine the prevalence and risk factors of anemia among human immunodeficiency virus (HIV)–infected women in Rwanda and the influence of highly active antiretroviral therapy (HAART) on anemia, we analyzed 200 HIV-positive women and 50 HIV-negative women in a cross-sectional study. Clinical examinations and iron and vitamin B12 assays were performed, and complete blood counts, serum folic acid levels, and CD4 cell count determined. The prevalence of anemia was significantly higher among HIV-positive women (29%) than among HIV-negative women (8%) (P < 0.001). Risk factors for anemia were lower body mass index (odds ratio [OR] = 3.4, 95% confidence interval [CI] = 2.4–4.1), zidovudine use (OR = 1.14, 95% CI = 1.01–1.29), lack of HAART (OR = 1.44, 95% CI = 1.21–1.67), oral candidiasis (OR = 1.4, 95% CI = 1.2–1.6), pulmonary tuberculosis (OR = 1.8, 95% CI = 1.7–2.2), cryptococcal meningitis (OR = 1.6, 95% CI = 1.21–1.8), Pneumocystis jiroveci pneumonia (OR = 1.41, 95% CI = 1.20–1.65) and CD4 lymphocyte count < 200 cells/μL (OR = 2.41, 95% CI = 2.01–3.07). The mean ± SD hemoglobin level of 10.9 ± 1.6 g/dL at HAART initiation significantly increased to 12.3 ± 1.5 g/dL in 8 months (P < 0.001). Anemia increases with HIV stage, and HAART is associated with a significant improvement in hemoglobin levels.

Author Notes

*Address correspondence to Jean Bosco Gahutu, Faculty of Medicine, National University of Rwanda, PO Box 30, Huye, Rwanda. E-mail: jgahutu@nur.ac.rw

Financial support: This study was supported by the Flemish InterUniversity Council in cooperation with the National University of Rwanda, Faculty of Medicine. Project reference: ZEIN2007PR342.

Authors' addresses: Florence Masaisa, Jean Bosco Gahutu, and Joshua Mukiibi, Faculty of Medicine, National University of Rwanda, Huye, Rwanda, E-mails: kabasius@yahoo.fr, jgahutu@nur.ac.rw, and jmukiibi@nur.ac.rw. Joris Delanghe and Jan Philippé, Ghent University Hospital, Ghent, Belgium, E-mails: joris.delanghe@ugent.be and jan.philippe@ugent.be.

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