Factors associated with anaemia in HIV-infected individuals in southern India.

Anemia accelerates disease progression and increases mortality among HIV-infected individuals. Few studies have characterized this problem in developing countries. Hemoglobin values of adults presenting to an HIV tertiary care center in India between 1996 and 2007 were collected (n=6996). Multivariate logistic regression analysis was performed to examine associations among anemia, HIV progression, and co-morbidities. Overall anemia prevalence was 41%. Twenty percent of patients with CD4 counts >500 cells/µL were anemic, compared to 64% of those with CD4 counts <100 cells/µL (p<0.001). In multivariate analysis, CD4 count <100 cells/µL (OR:5.0, CI:4.0–6.3), underweight body-mass index (OR:4.8, CI:3.6–6.5), female gender (OR:3.1, CI:2.8–3.6), and tuberculosis (OR:1.6, CI:1.4–1.8) were significantly associated with anemia. In this setting, management of anemia should focus on antiretroviral therapy, nutritional supplementation, and tuberculosis control. The high anemia prevalence among patients meeting criteria for antiretroviral therapy highlights the need for increased access to non-AZT nucleoside reverse transcriptase inhibitors in developing countries.