Prevalence of Anaemia after Initiation of Antiretroviral Therapy among HIV-infected Patients Attending University of Calabar Teaching Hospital Calabar, Nigeria

Abstract

Aims: To investigating some demographic variables and red cell parameters of infected persons already accessing antiretroviral therapy with a view to identifying sub- groups with higher proportions of anaemia.  Study Design:  Cross-sectional study. Place and Duration of Study: University of Calabar Teaching Hospital Calabar Nigeria, between August 2017 and July 2018. Methodology: Subjects comprised 60 male and female HIV-infected adults attending University of Calabar Teaching Hospital Calabar, and equal number of age and sex-matched control subjects who were HIV sero-negative as at the time of this study. The infected persons were being treated with either Tenofovir+Lamivudine+Efavirenz (TLE) or Lamivudine+Zidovudine+Nevirapine (LZN). A pre-tested structured questionnaire was administered by two trained interviewers which captured the bio-data, sociodemographic variables and therapy-related information. Venous blood was collected aseptically by standard phlebotomy into appropriate sample containers for CD4 and red cell counts by automation. Results: The proportion of anaemia occurring between TLE and LZN users was observed to be in the ratio of 2:3. The RBC count, haematocrit and haemoglobin concentration were significantly lower (p=.000), while MCV, MCH and RDW were significantly higher (p=.000) in subjects infected with HIV compared to the control subjects, Duration of treatment beyond 6 years significantly raised both MCV (p=.007) and MCH (p=.006) compared to the first 3 years of treatment commencement, while the MCV, MCH and RDW-SD were significantly higher (p=.003, .014 and .018 respectively) among LZN users compared to those on TLE. Conclusion: Human immunodeficiency virus infection triggers pathologic mechanisms that culminate into anaemia. While the use of antiretroviral therapy appears to gradually resolve this derangement, the adverse effects of some of the antiretroviral agents contribute to the persistence of anaemia particularly with increasing years of treatment.