Rosalind Parkes-Ratanshi1, David Katende2, Jonathan Levin3, Katie Wakeham4, Grosskurth Heiner5, Anatoli Kamali2, David G Lalloo6. 1. MRC/UVRI Uganda Research Unit on AIDS, Uganda Virus Research Institute (UVRI), Entebbe, Uganda Liverpool School of Tropical Medicine, Liverpool, United Kingdom Infectious Diseases Insitute, Kampala, Uganda rratanshi@idi.co.ug. 2. MRC/UVRI Uganda Research Unit on AIDS, Uganda Virus Research Institute (UVRI), Entebbe, Uganda. 3. MRC/UVRI Uganda Research Unit on AIDS, Uganda Virus Research Institute (UVRI), Entebbe, Uganda University of Witwatersrand, Johannesburg, South Africa. 4. MRC/UVRI Uganda Research Unit on AIDS, Uganda Virus Research Institute (UVRI), Entebbe, Uganda Liverpool School of Tropical Medicine, Liverpool, United Kingdom Epidemiology and Genetics Unit, University of York, York, United Kingdom. 5. MRC/UVRI Uganda Research Unit on AIDS, Uganda Virus Research Institute (UVRI), Entebbe, Uganda London School of Tropical Medicine and Hygiene, London, United Kingdom. 6. Liverpool School of Tropical Medicine, Liverpool, United Kingdom Infectious Diseases Insitute, Kampala, Uganda.
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.
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.
Authors: Rosalind Parkes-Ratanshi; Katie Wakeham; Jonathan Levin; Deodata Namusoke; James Whitworth; Alex Coutinho; Nathan Kenya Mugisha; Heiner Grosskurth; Anatoli Kamali; David G Lalloo Journal: Lancet Infect Dis Date: 2011-10-06 Impact factor: 25.071
Authors: Richard D Semba; Nina Shah; Robert S Klein; Kenneth H Mayer; Paula Schuman; David Vlahov Journal: Clin Infect Dis Date: 2001-12-04 Impact factor: 9.079
Authors: E W C Nacoulma; Y Some; H Tieno; I Diallo; A Zoungrana; R Bougnounou; C Ouédraogo; J Drabo; J B Guiard-Schmid Journal: Bull Soc Pathol Exot Date: 2007-10
Authors: Joseph O Mugisha; Leigh Anne Shafer; Lieve Van der Paal; Billy N Mayanja; Henry Eotu; Peter Hughes; Jimmy A G Whitworth; Heiner Grosskurth Journal: Trop Med Int Health Date: 2008-03-31 Impact factor: 2.622
Authors: Jialun Zhou; Antoine Jaquet; Emmanuel Bissagnene; Beverly Musick; Kara Wools-Kaloustian; Nicola Maxwell; Andrew Boulle; Firas Wehbe; Daniel Masys; Jeniffer Iriondo-Perez; Jay Hemingway-Foday; Matthew Law Journal: J Int AIDS Soc Date: 2012-01-30 Impact factor: 5.396
Authors: P Mugyenyi; A S Walker; J Hakim; P Munderi; D M Gibb; C Kityo; A Reid; H Grosskurth; J H Darbyshire; F Ssali; D Bray; E Katabira; A G Babiker; C F Gilks; H Grosskurth; P Munderi; G Kabuye; D Nsibambi; R Kasirye; E Zalwango; M Nakazibwe; B Kikaire; G Nassuna; R Massa; K Fadhiru; M Namyalo; A Zalwango; L Generous; P Khauka; N Rutikarayo; W Nakahima; A Mugisha; J Todd; J Levin; S Muyingo; A Ruberantwari; P Kaleebu; D Yirrell; N Ndembi; F Lyagoba; P Hughes; M Aber; A Medina Lara; S Foster; J Amurwon; B Nyanzi Wakholi; J Whitworth; K Wangati; B Amuron; D Kajungu; J Nakiyingi; W Omony; K Fadhiru; D Nsibambi; P Khauka; P Mugyenyi; C Kityo; F Ssali; D Tumukunde; T Otim; J Kabanda; H Musana; J Akao; H Kyomugisha; A Byamukama; J Sabiiti; J Komugyena; P Wavamunno; S Mukiibi; A Drasiku; R Byaruhanga; O Labeja; P Katundu; S Tugume; P Awio; A Namazzi; G T Bakeinyaga; H Katabira; D Abaine; J Tukamushaba; W Anywar; W Ojiambo; E Angweng; S Murungi; W Haguma; S Atwiine; J Kigozi; L Namale; A Mukose; G Mulindwa; D Atwiine; A Muhwezi; E Nimwesiga; G Barungi; J Takubwa; S Murungi; D Mwebesa; G Kagina; M Mulindwa; F Ahimbisibwe; P Mwesigwa; S Akuma; C Zawedde; D Nyiraguhirwa; C Tumusiime; L Bagaya; W Namara; J Kigozi; J Karungi; R Kankunda; R Enzama; A Latif; J Hakim; V Robertson; A Reid; E Chidziva; R Bulaya-Tembo; G Musoro; F Taziwa; C Chimbetete; L Chakonza; A Mawora; C Muvirimi; G Tinago; P Svovanapasis; M Simango; O Chirema; J Machingura; S Mutsai; M Phiri; T Bafana; M Chirara; L Muchabaiwa; M Muzambi; J Mutowo; T Chivhunga; E Chigwedere; M Pascoe; C Warambwa; E Zengeza; F Mapinge; S Makota; A Jamu; N Ngorima; H Chirairo; S Chitsungo; J Chimanzi; C Maweni; R Warara; M Matongo; S Mudzingwa; M Jangano; K Moyo; L Vere; N Mdege; I Machingura; E Katabira; A Ronald; A Kambungu; F Lutwama; I Mambule; A Nanfuka; J Walusimbi; E Nabankema; R Nalumenya; T Namuli; R Kulume; I Namata; L Nyachwo; A Florence; A Kusiima; E Lubwama; R Nairuba; F Oketta; E Buluma; R Waita; H Ojiambo; F Sadik; J Wanyama; P Nabongo; J Oyugi; F Sematala; A Muganzi; C Twijukye; H Byakwaga; R Ochai; D Muhweezi; A Coutinho; B Etukoit; C Gilks; K Boocock; C Puddephatt; C Grundy; J Bohannon; D Winogron; D M Gibb; A Burke; D Bray; A Babiker; A S Walker; H Wilkes; M Rauchenberger; S Sheehan; C Spencer-Drake; K Taylor; M Spyer; A Ferrier; B Naidoo; D Dunn; R Goodall; J H Darbyshire; L Peto; R Nanfuka; C Mufuka-Kapuya; P Kaleebu; D Pillay; V Robertson; D Yirrell; S Tugume; M Chirara; P Katundu; N Ndembi; F Lyagoba; D Dunn; R Goodall; A McCormick; A Medina Lara; S Foster; J Amurwon; B Nyanzi Wakholi; J Kigozi; L Muchabaiwa; M Muzambi; I Weller; A Babiker; S Bahendeka; M Bassett; A Chogo Wapakhabulo; J H Darbyshire; B Gazzard; C Gilks; H Grosskurth; J Hakim; A Latif; C Mapuchere; O Mugurungi; P Mugyenyi; C Burke; S Jones; C Newland; G Pearce; S Rahim; J Rooney; M Smith; W Snowden; J-M Steens; A Breckenridge; A McLaren; C Hill; J Matenga; A Pozniak; D Serwadda; T Peto; A Palfreeman; M Borok; E Katabira Journal: Lancet Date: 2009-12-08 Impact factor: 79.321
Authors: L Tugume; B M Morawski; M Abassi; N C Bahr; R Kiggundu; H W Nabeta; K H Hullsiek; K Taseera; A K Musubire; C Schutz; C Muzoora; D A Williams; M A Rolfes; G Meintjes; J Rhein; D B Meya; D R Boulware Journal: HIV Med Date: 2016-04-28 Impact factor: 3.180
Authors: Fiona Vanobberghen; Emilio Letang; Anna Gamell; Dorcas K Mnzava; Diana Faini; Lameck B Luwanda; Herry Mapesi; Kim Mwamelo; George Sikalengo; Marcel Tanner; Christoph Hatz; Hansjakob Furrer; Manuel Battegay; Tracy R Glass Journal: PLoS One Date: 2017-07-18 Impact factor: 3.240
Authors: Eric Nagaonlé Somé; Ingunn M S Engebretsen; Nicolas Nagot; Nicolas Y Meda; Roselyne Vallo; Chipepo Kankasa; James K Tumwine; Mandisa Singata; Justus G Hofmeyr; Philippe Van de Perre; Thorkild Tylleskär Journal: PLoS One Date: 2017-05-09 Impact factor: 3.240