Abstract

Anaemia is an important clinical problem in patients with HIV infection and those with AIDS. The causes of anaemia in HIV infection are multifactorial. HIV per se causes decrease in production of RBCs and other bone marrow elements, as it has direct effect on bone marrow stromal cells and cause cytokine secretion. The elevated level of cytokines and Tumour necrosis factor further inhibit haematopoiesis in HIV. There is also evidence of increased risk of anaemia in association with zidovudine use, CD4 cell counts of <200 cells/μl and high viral load. This study was conducted to find out the incidence of anaemia among patients with HIV and its association with WHO clinical staging, CD4 count and Anti- Retroviral Therapy (ART). The study was conducted at department of medicine of a tertiary care teaching hospital in western Maharashtra from July 2015 to September 2016. A total of 316 patients (106 Outpatients and 214 indoor patients) were included in the study. Significantly high prevalence of anaemia was seen in patients in WHO stage II-IV, with the highest prevalence in stage III. Although anaemia was seen in all levels of CD4 counts, anaemia prevalence 89.5% was significantly high in patients with CD4 count >< 200 cells/μl. The patients not on ART had higher prevalence of anemia than those who were receiving ART, regardless of whether the regimen was AZT containing or not. The study highlights that advanced disease, low CD+ count and non-exposure to ART are adverse risk factors for development of anemia among HIV patients.