The study of anemia in HIV/ AIDS patients who received Zidovudine (AZT) at Kumpavapee hospital
Keywords:
HIV, AIDS, Zidovudine (AZT), AnemiaAbstract
Objective: To study characteristics and prevalence of anemia before treatment in HIV/AIDS patients and determine factors affecting anemia in HIV/ AIDS patients who received Zidovudine (AZT).
Method: A retrospective descriptive study of patients from the age of 16 with HIV/AIDS attending the HIV clinic (NAPHA clinic) and receiving antiretroviral drugs at Kumpavapee hospital between 1st October 2010 and 30th September 2015 were enrolled in this study. A demographic data (included sex, age, body weight, underlying diseases, co morbidity, opportunistic infection and medications) and investigations (included CBC, creatinine, AST, ALT, ALP,CD4 count and viral load) were done for all patients. Meanwhile patients with incomplete data were excluded from this study.
Results: Enrolled were 125 patients of whom 63 (50.4%) were male. The mean (SD) age of the patients was 41.33 (8.10) years. Most patients had underlying diseases such as dyslipidemia, hypertension and diabetes mellitus. Opportunistic infections were found 52% (TB, Cryptococcus, PCP, etc). The mean (SD) CD4 level before treatment was 106.9 (94.18) cells/ml. Prevalence of anemia before treatment is 20.8% (26 cases). The first regimen (d4T based regimen) includes 111 cases (88.8%). The adaptive regimen (AZT based regimen) includes 101cases (80.8%). After we use the adaptive regimen, 79 (63.2%) and 49 (39.2%) patients had anemia and lipodystrophy respectively. Significant factors affecting anemia in HIV/AIDS patients who received AZT were female (p=0.042) and CD4 level < 200 cells/ml (p=0.047). Then we change antiretroviral drugs to current regimen 86 cases (68.8%). And after we revised and developed NAPHA clinic continuously, we can achieve goal of treatment (CD4 level > 200 cells/ml) from 6 months. The mean (SD) CD4 level after treatment 1 year was 314.8 (176.2) cells/ml and the mean (SD) viral load level after treatment 1 year and 2 years were 649.27 (6,965.6) and 15.15 (68.3) copies/ml respectively.
Conclusion: Female sex and CD4 level < 200 cells/ml were significant factors affecting anemia in HIV/AIDS patients who received AZT. So we can apply this knowledge for follow up and prevent anemia in these high risk patients.
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