Impact of highly active antiretroviral therapy on anemia and relationship between anemia and survival in a large cohort of HIV-infected women: Women's interagency HIV study

Kiros Berhane, Roksana Karim, Mardge H. Cohen, Lena Masri-Lavine, Mary Young, Kathryn Anastos, Michael Augenbraun, D. Heather Watts, Alexandra M. Levine

Research output: Contribution to journalArticle

87 Citations (Scopus)

Abstract

Background: Anemia is common in HIV-infected individuals and may be associated with decreased survival. Objective: To ascertain the impact of highly active antiretroviral therapy (HAART) on anemia and the relationship between anemia and overall survival in HIV-infected women. Methods: A prospective multicenter study of HIV-1 infection in women. Visits occurred every 6 months, including a standardized history, physical examination, and comprehensive laboratory evaluation. The setting was a university-affiliated clinic at 6 sites in the United States. Participants were 2056 HIV-infected women from the Women's Interagency HIV Study (WIHS). The outcome measure was anemia, defined as hemoglobin (Hb) <12 g/dL. Survival analysis was based on overall mortality during the follow-up period. Results: Among HIV-infected women who were not anemic at baseline, 47% became anemic by 3.5 years of follow-up. On multivariate analysis, the use of HAART was associated with resolution of anemia even when used for only 6 months (odds ratio [OR] = 1.45; P < 0.05). In the multivariate model, a CD4 cell count <200 cells/μL (OR = 0.56; P < 0.001); HIV-1 RNA level ≥50,000 copies/mL (OR = 0.65; P < 0.001), and mean corpuscular volume (MCV) value <80 fL (OR = 0.40; P < 0.001) were also associated with an inability to correct anemia. Similarly, use of HAART for 12 months or more was associated with a protective effect against development of anemia (OR = 0.71; P < 0.001). Among HIV-infected women, anemia was independently associated with decreased survival (hazard ratio [HR] = 2.58; P < 0.001). Other factors associated with decreased survival included a CD4 cell count <200 cells/μL (HR = 5.83; P < 0.001), HIV-1 RNA level ≥50,000 copies/mL (HR = 2.12; P < 0.001), and clinical diagnosis of AIDS (HR = 2.83; P < 0.001). Conclusions: Anemia is an independent risk factor for decreased survival among HIV-infected women. HAART therapy for as little as 6 months is associated with resolution of anemia.

Original languageEnglish (US)
Pages (from-to)1245-1252
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Volume37
Issue number2
DOIs
StatePublished - Oct 1 2004

Fingerprint

Highly Active Antiretroviral Therapy
Anemia
HIV
Survival
Odds Ratio
HIV-1
CD4 Lymphocyte Count
RNA
Erythrocyte Indices
Survival Analysis
Multicenter Studies
Physical Examination
HIV Infections
Acquired Immunodeficiency Syndrome
Hemoglobins
Multivariate Analysis
History
Outcome Assessment (Health Care)
Prospective Studies
Mortality

Keywords

  • AIDS
  • Anemia
  • HIV
  • Survival
  • Women

ASJC Scopus subject areas

  • Virology
  • Immunology

Cite this

Impact of highly active antiretroviral therapy on anemia and relationship between anemia and survival in a large cohort of HIV-infected women : Women's interagency HIV study. / Berhane, Kiros; Karim, Roksana; Cohen, Mardge H.; Masri-Lavine, Lena; Young, Mary; Anastos, Kathryn; Augenbraun, Michael; Watts, D. Heather; Levine, Alexandra M.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 37, No. 2, 01.10.2004, p. 1245-1252.

Research output: Contribution to journalArticle

Berhane, Kiros ; Karim, Roksana ; Cohen, Mardge H. ; Masri-Lavine, Lena ; Young, Mary ; Anastos, Kathryn ; Augenbraun, Michael ; Watts, D. Heather ; Levine, Alexandra M. / Impact of highly active antiretroviral therapy on anemia and relationship between anemia and survival in a large cohort of HIV-infected women : Women's interagency HIV study. In: Journal of Acquired Immune Deficiency Syndromes. 2004 ; Vol. 37, No. 2. pp. 1245-1252.
@article{8ae38f64bc604d37bae61092e886596b,
title = "Impact of highly active antiretroviral therapy on anemia and relationship between anemia and survival in a large cohort of HIV-infected women: Women's interagency HIV study",
abstract = "Background: Anemia is common in HIV-infected individuals and may be associated with decreased survival. Objective: To ascertain the impact of highly active antiretroviral therapy (HAART) on anemia and the relationship between anemia and overall survival in HIV-infected women. Methods: A prospective multicenter study of HIV-1 infection in women. Visits occurred every 6 months, including a standardized history, physical examination, and comprehensive laboratory evaluation. The setting was a university-affiliated clinic at 6 sites in the United States. Participants were 2056 HIV-infected women from the Women's Interagency HIV Study (WIHS). The outcome measure was anemia, defined as hemoglobin (Hb) <12 g/dL. Survival analysis was based on overall mortality during the follow-up period. Results: Among HIV-infected women who were not anemic at baseline, 47{\%} became anemic by 3.5 years of follow-up. On multivariate analysis, the use of HAART was associated with resolution of anemia even when used for only 6 months (odds ratio [OR] = 1.45; P < 0.05). In the multivariate model, a CD4 cell count <200 cells/μL (OR = 0.56; P < 0.001); HIV-1 RNA level ≥50,000 copies/mL (OR = 0.65; P < 0.001), and mean corpuscular volume (MCV) value <80 fL (OR = 0.40; P < 0.001) were also associated with an inability to correct anemia. Similarly, use of HAART for 12 months or more was associated with a protective effect against development of anemia (OR = 0.71; P < 0.001). Among HIV-infected women, anemia was independently associated with decreased survival (hazard ratio [HR] = 2.58; P < 0.001). Other factors associated with decreased survival included a CD4 cell count <200 cells/μL (HR = 5.83; P < 0.001), HIV-1 RNA level ≥50,000 copies/mL (HR = 2.12; P < 0.001), and clinical diagnosis of AIDS (HR = 2.83; P < 0.001). Conclusions: Anemia is an independent risk factor for decreased survival among HIV-infected women. HAART therapy for as little as 6 months is associated with resolution of anemia.",
keywords = "AIDS, Anemia, HIV, Survival, Women",
author = "Kiros Berhane and Roksana Karim and Cohen, {Mardge H.} and Lena Masri-Lavine and Mary Young and Kathryn Anastos and Michael Augenbraun and Watts, {D. Heather} and Levine, {Alexandra M.}",
year = "2004",
month = "10",
day = "1",
doi = "10.1097/01.qai.0000134759.01684.27",
language = "English (US)",
volume = "37",
pages = "1245--1252",
journal = "Journal of Acquired Immune Deficiency Syndromes",
issn = "1525-4135",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Impact of highly active antiretroviral therapy on anemia and relationship between anemia and survival in a large cohort of HIV-infected women

T2 - Women's interagency HIV study

AU - Berhane, Kiros

AU - Karim, Roksana

AU - Cohen, Mardge H.

AU - Masri-Lavine, Lena

AU - Young, Mary

AU - Anastos, Kathryn

AU - Augenbraun, Michael

AU - Watts, D. Heather

AU - Levine, Alexandra M.

PY - 2004/10/1

Y1 - 2004/10/1

N2 - Background: Anemia is common in HIV-infected individuals and may be associated with decreased survival. Objective: To ascertain the impact of highly active antiretroviral therapy (HAART) on anemia and the relationship between anemia and overall survival in HIV-infected women. Methods: A prospective multicenter study of HIV-1 infection in women. Visits occurred every 6 months, including a standardized history, physical examination, and comprehensive laboratory evaluation. The setting was a university-affiliated clinic at 6 sites in the United States. Participants were 2056 HIV-infected women from the Women's Interagency HIV Study (WIHS). The outcome measure was anemia, defined as hemoglobin (Hb) <12 g/dL. Survival analysis was based on overall mortality during the follow-up period. Results: Among HIV-infected women who were not anemic at baseline, 47% became anemic by 3.5 years of follow-up. On multivariate analysis, the use of HAART was associated with resolution of anemia even when used for only 6 months (odds ratio [OR] = 1.45; P < 0.05). In the multivariate model, a CD4 cell count <200 cells/μL (OR = 0.56; P < 0.001); HIV-1 RNA level ≥50,000 copies/mL (OR = 0.65; P < 0.001), and mean corpuscular volume (MCV) value <80 fL (OR = 0.40; P < 0.001) were also associated with an inability to correct anemia. Similarly, use of HAART for 12 months or more was associated with a protective effect against development of anemia (OR = 0.71; P < 0.001). Among HIV-infected women, anemia was independently associated with decreased survival (hazard ratio [HR] = 2.58; P < 0.001). Other factors associated with decreased survival included a CD4 cell count <200 cells/μL (HR = 5.83; P < 0.001), HIV-1 RNA level ≥50,000 copies/mL (HR = 2.12; P < 0.001), and clinical diagnosis of AIDS (HR = 2.83; P < 0.001). Conclusions: Anemia is an independent risk factor for decreased survival among HIV-infected women. HAART therapy for as little as 6 months is associated with resolution of anemia.

AB - Background: Anemia is common in HIV-infected individuals and may be associated with decreased survival. Objective: To ascertain the impact of highly active antiretroviral therapy (HAART) on anemia and the relationship between anemia and overall survival in HIV-infected women. Methods: A prospective multicenter study of HIV-1 infection in women. Visits occurred every 6 months, including a standardized history, physical examination, and comprehensive laboratory evaluation. The setting was a university-affiliated clinic at 6 sites in the United States. Participants were 2056 HIV-infected women from the Women's Interagency HIV Study (WIHS). The outcome measure was anemia, defined as hemoglobin (Hb) <12 g/dL. Survival analysis was based on overall mortality during the follow-up period. Results: Among HIV-infected women who were not anemic at baseline, 47% became anemic by 3.5 years of follow-up. On multivariate analysis, the use of HAART was associated with resolution of anemia even when used for only 6 months (odds ratio [OR] = 1.45; P < 0.05). In the multivariate model, a CD4 cell count <200 cells/μL (OR = 0.56; P < 0.001); HIV-1 RNA level ≥50,000 copies/mL (OR = 0.65; P < 0.001), and mean corpuscular volume (MCV) value <80 fL (OR = 0.40; P < 0.001) were also associated with an inability to correct anemia. Similarly, use of HAART for 12 months or more was associated with a protective effect against development of anemia (OR = 0.71; P < 0.001). Among HIV-infected women, anemia was independently associated with decreased survival (hazard ratio [HR] = 2.58; P < 0.001). Other factors associated with decreased survival included a CD4 cell count <200 cells/μL (HR = 5.83; P < 0.001), HIV-1 RNA level ≥50,000 copies/mL (HR = 2.12; P < 0.001), and clinical diagnosis of AIDS (HR = 2.83; P < 0.001). Conclusions: Anemia is an independent risk factor for decreased survival among HIV-infected women. HAART therapy for as little as 6 months is associated with resolution of anemia.

KW - AIDS

KW - Anemia

KW - HIV

KW - Survival

KW - Women

UR - http://www.scopus.com/inward/record.url?scp=4644295283&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=4644295283&partnerID=8YFLogxK

U2 - 10.1097/01.qai.0000134759.01684.27

DO - 10.1097/01.qai.0000134759.01684.27

M3 - Article

C2 - 15385731

AN - SCOPUS:4644295283

VL - 37

SP - 1245

EP - 1252

JO - Journal of Acquired Immune Deficiency Syndromes

JF - Journal of Acquired Immune Deficiency Syndromes

SN - 1525-4135

IS - 2

ER -