Development of Severe Anemia and 
Changes in Hemoglobin in a Cohort of 
HIV-Infected Ugandan Adults Receiving 
Zidovudine-, Stavudine-, and 
Tenofovir-Containing Antiretroviral Regimens

Rosalind Parkes-Ratanshi; David Katende; Jonathan Levin; Katie Wakeham; Grosskurth Heiner; Anatoli Kamali; David Lalloo

doi:10.1177/2325957414557264

Development of Severe Anemia and Changes in Hemoglobin in a Cohort of HIV-Infected Ugandan Adults Receiving Zidovudine-, Stavudine-, and Tenofovir-Containing Antiretroviral Regimens

Rosalind Parkes-Ratanshi, David Katende, Jonathan Levin, Katie Wakeham, Grosskurth Heiner, Anatoli Kamali, David Lalloo

Clinical Sciences

Research output: Contribution to journal › Article › peer-review

22 Citations (Scopus)

Abstract

Introduction

Anemia is a common problem in HIV in sub-Saharan Africa. We describe the contribution of antiretroviral therapy (ART) regimen to the incidence of anemia and changes in hemoglobin (Hb) in HIV-infected patients in Uganda.

Methods

This study was nested in a prevention of cryptococcal disease trial (CRYPTOPRO; ISCRTN7648152). Patients received 3 different backbones of nucleoside reverse transcriptase inhibitor in a nonrandomized manner.

Results

Of the 852 patients (161 on zidovudine [ZDV], 628 on stavudine [d4T], and 63 on tenofovir [TDF]; all received lamuvidine), the risk of developing grade 4 anemia was higher (adjusted hazard ratio 2.7) for those receiving ZDV than those receiving d4T. Those receivingd4T had a higher average increase in Hb than those receiving ZDV (P = .024) or TDF (P = .014).

Conclusion

In this observational study, ZDV was associated with severe anemia compared to d4T or TDF; those receiving ZDV and TDF had smaller increases in Hb after ART initiation. We encourage publication of data on cohorts using TDF from Africa.

Original language	English
Pages (from-to)	455-462
Number of pages	8
Journal	Journal of the International Association of Providers of AIDS Care
Volume	14
Issue number	5
DOIs	https://doi.org/10.1177/2325957414557264
Publication status	Published - 25 Nov 2014

Keywords

Africa
anemia
ART
hemoglobin
tenofovir
Uganda
zidovudine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1177/2325957414557264

Cite this

Parkes-Ratanshi, R., Katende, D., Levin, J., Wakeham, K., Heiner, G., Kamali, A., & Lalloo, D. (2014). Development of Severe Anemia and Changes in Hemoglobin in a Cohort of HIV-Infected Ugandan Adults Receiving Zidovudine-, Stavudine-, and Tenofovir-Containing Antiretroviral Regimens. Journal of the International Association of Providers of AIDS Care, 14(5), 455-462. https://doi.org/10.1177/2325957414557264

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abstract = "IntroductionAnemia is a common problem in HIV in sub-Saharan Africa. We describe the contribution of antiretroviral therapy (ART) regimen to the incidence of anemia and changes in hemoglobin (Hb) in HIV-infected patients in Uganda. MethodsThis study was nested in a prevention of cryptococcal disease trial (CRYPTOPRO; ISCRTN7648152). Patients received 3 different backbones of nucleoside reverse transcriptase inhibitor in a nonrandomized manner. ResultsOf the 852 patients (161 on zidovudine [ZDV], 628 on stavudine [d4T], and 63 on tenofovir [TDF]; all received lamuvidine), the risk of developing grade 4 anemia was higher (adjusted hazard ratio 2.7) for those receiving ZDV than those receiving d4T. Those receivingd4T had a higher average increase in Hb than those receiving ZDV (P = .024) or TDF (P = .014). ConclusionIn this observational study, ZDV was associated with severe anemia compared to d4T or TDF; those receiving ZDV and TDF had smaller increases in Hb after ART initiation. We encourage publication of data on cohorts using TDF from Africa.",

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author = "Rosalind Parkes-Ratanshi and David Katende and Jonathan Levin and Katie Wakeham and Grosskurth Heiner and Anatoli Kamali and David Lalloo",

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Parkes-Ratanshi, R, Katende, D, Levin, J, Wakeham, K, Heiner, G, Kamali, A & Lalloo, D 2014, 'Development of Severe Anemia and Changes in Hemoglobin in a Cohort of HIV-Infected Ugandan Adults Receiving Zidovudine-, Stavudine-, and Tenofovir-Containing Antiretroviral Regimens', Journal of the International Association of Providers of AIDS Care, vol. 14, no. 5, pp. 455-462. https://doi.org/10.1177/2325957414557264

Development of Severe Anemia and Changes in Hemoglobin in a Cohort of HIV-Infected Ugandan Adults Receiving Zidovudine-, Stavudine-, and Tenofovir-Containing Antiretroviral Regimens. / Parkes-Ratanshi, Rosalind; Katende, David; Levin, Jonathan et al.
In: Journal of the International Association of Providers of AIDS Care, Vol. 14, No. 5, 25.11.2014, p. 455-462.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Development of Severe Anemia and Changes in Hemoglobin in a Cohort of HIV-Infected Ugandan Adults Receiving Zidovudine-, Stavudine-, and Tenofovir-Containing Antiretroviral Regimens

AU - Parkes-Ratanshi, Rosalind

AU - Katende, David

AU - Levin, Jonathan

AU - Wakeham, Katie

AU - Heiner, Grosskurth

AU - Kamali, Anatoli

AU - Lalloo, David

PY - 2014/11/25

Y1 - 2014/11/25

N2 - IntroductionAnemia is a common problem in HIV in sub-Saharan Africa. We describe the contribution of antiretroviral therapy (ART) regimen to the incidence of anemia and changes in hemoglobin (Hb) in HIV-infected patients in Uganda. MethodsThis study was nested in a prevention of cryptococcal disease trial (CRYPTOPRO; ISCRTN7648152). Patients received 3 different backbones of nucleoside reverse transcriptase inhibitor in a nonrandomized manner. ResultsOf the 852 patients (161 on zidovudine [ZDV], 628 on stavudine [d4T], and 63 on tenofovir [TDF]; all received lamuvidine), the risk of developing grade 4 anemia was higher (adjusted hazard ratio 2.7) for those receiving ZDV than those receiving d4T. Those receivingd4T had a higher average increase in Hb than those receiving ZDV (P = .024) or TDF (P = .014). ConclusionIn this observational study, ZDV was associated with severe anemia compared to d4T or TDF; those receiving ZDV and TDF had smaller increases in Hb after ART initiation. We encourage publication of data on cohorts using TDF from Africa.

AB - IntroductionAnemia is a common problem in HIV in sub-Saharan Africa. We describe the contribution of antiretroviral therapy (ART) regimen to the incidence of anemia and changes in hemoglobin (Hb) in HIV-infected patients in Uganda. MethodsThis study was nested in a prevention of cryptococcal disease trial (CRYPTOPRO; ISCRTN7648152). Patients received 3 different backbones of nucleoside reverse transcriptase inhibitor in a nonrandomized manner. ResultsOf the 852 patients (161 on zidovudine [ZDV], 628 on stavudine [d4T], and 63 on tenofovir [TDF]; all received lamuvidine), the risk of developing grade 4 anemia was higher (adjusted hazard ratio 2.7) for those receiving ZDV than those receiving d4T. Those receivingd4T had a higher average increase in Hb than those receiving ZDV (P = .024) or TDF (P = .014). ConclusionIn this observational study, ZDV was associated with severe anemia compared to d4T or TDF; those receiving ZDV and TDF had smaller increases in Hb after ART initiation. We encourage publication of data on cohorts using TDF from Africa.

KW - Africa

KW - anemia

KW - ART

KW - hemoglobin

KW - tenofovir

KW - Uganda

KW - zidovudine

U2 - 10.1177/2325957414557264

DO - 10.1177/2325957414557264

M3 - Article

SN - 2325-9574

VL - 14

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EP - 462

JO - Journal of the International Association of Providers of AIDS Care

JF - Journal of the International Association of Providers of AIDS Care

IS - 5

ER -