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Prevalence and Correlates of Anemia in a Large Cohort of HIV-Infected Women: Women's Interagency HIV Study

Levine Alexandra M.; Berhane, Kiros; Masri-Lavine, Lena; Sanchez, Maria Lynn; Young, Mary; Augenbraun, Michael; Cohen, Mardge; Anastos, Kathryn; Newman, Margaret; Gange, Stephen J.; Watts, Heather
JAIDS Journal of Acquired Immune Deficiency Syndromes: January 1st, 2001
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Summary:Anemia is a common manifestation of HIV infection, occurring in approximately 30% of patients with asymptomatic infection and in as many as 75% to 80% of those with AIDS. Anemia has been associated with decreased quality of life and decreased survival. We performed a cross-sectional study nested within a multicenter prospective cohort study to describe the prevalence of anemia in 2056 HIVinfected and 569 HIV-negative women as well as to define the demographic, clinical, immunologic, and virologic correlates of anemia among HIV-infected women. A total of 37% of HIV-positive women and 17% of HIV-negative women had hemoglobin levels < 12 g/dl (p < .001). Factors associated with anemia in HIV-positive and HIV-negative women included mean corpuscular volume (MCV) < 80 fl (p < .001) and black race (p < .001). Among HIV-infected women, multivariate logistic analyses revealed that African American race (p < .0001), MCV < 80 fl (p < .0001), CD4 count < 200 per microliter (p < .0001), higher HIV RNA in plasma (p = .02), current use of ZDV (p = .01), and history of clinical AIDS (p = .004) were all independent predictors of anemia. These data indicate that worsening parameters of HIV disease are associated with anemia among HIV-infected women. Black women and women with low MCV values are at increased risk for anemia independent of HIV status.

Address correspondence and reprint requests to Alexandra M. Levine, USC/Norris Cancer Hospital, 1441 Eastlake Avenue, MS 34, Los Angeles, CA 90033, U.S.A.; e-mail:

Manuscript received June 21, 2000; accepted September 14, 2000.

© 2001 Lippincott Williams & Wilkins, Inc.