{"id":5947,"date":"2020-05-24T09:58:18","date_gmt":"2020-05-24T08:58:18","guid":{"rendered":"https:\/\/www.library.sath.nhs.uk\/research\/?p=5947"},"modified":"2021-07-01T08:48:43","modified_gmt":"2021-07-01T07:48:43","slug":"severe-anaemia-complicating-hiv-in-malawi-multiple-co-existing-aetiologies-are-associated-with-high-mortality-2020","status":"publish","type":"post","link":"https:\/\/www.library.sath.nhs.uk\/research\/2020\/05\/24\/severe-anaemia-complicating-hiv-in-malawi-multiple-co-existing-aetiologies-are-associated-with-high-mortality-2020\/","title":{"rendered":"Severe anaemia complicating HIV in Malawi; Multiple co-existing aetiologies are associated with high mortality (2020)"},"content":{"rendered":"<p><strong>Type of publication:<\/strong><br \/>\nJournal article<\/p>\n<p><strong>Author(s):<\/strong><br \/>\nHuibers M.H.W.; van Hensbroek M.B.; Calis J.C.; Bates I.; *McKew S.; Allain T.J.; Phiri C.; Coupland S.E.; Phiri K.S.<\/p>\n<p><strong>Citation:<\/strong><br \/>\nPLoS ONE; 2020; vol. 15 (no. 2)<\/p>\n<p><strong>Abstract:<\/strong><br \/>\nBackground Severe anaemia is a major cause of morbidity and mortality in HIV-infected adults living in resource-limited countries. Comprehensive data on the aetiology are lacking but are needed to improve outcomes. Methods HIV-infected adults with severe (haemoglobin &lt;=70g\/l) or very severe anaemia (haemoglobin &lt;= 50 g\/l) were recruited at Queen Elizabeth Central Hospital, Blantyre, Malawi. Fifteen potential causes and associations with anaemia severity and mortality were explored. Results 199 patients were enrolled: 42.2% had very severe anaemia and 45.7% were on ART. More than two potential causes for anaemia were present in 94% of the patients including iron deficiency (55.3%), underweight (BMI&lt;20: 49.7%), TB infection (41.2%) and unsuppressed HIV infection (viral load &gt;1000 copies\/ml) (73.9%). EBV\/CMV co-infection (16.5%) was associated with very severe anaemia (OR 2.8 95% CI 1.1-6.9). Overall mortality was high (53%; 100\/199) with a median time to death of 17.5 days (IQR 6-55) days. Death was associated with folate deficiency (HR 2.2; 95% CI 1.2-3.8) and end stage renal disease (HR 3.2; 95% CI 1.6-6.2). Conclusion Mortality among severely anaemic HIV-infected adults is strikingly high. Clinicians should be aware of the urgent need for a multifactorial approach including starting or optimising HIV treatment, considering TB treatment, nutritional support and optimising renal management.<\/p>\n<p><a href=\"https:\/\/journals.plos.org\/plosone\/article\/file?id=10.1371\/journal.pone.0218695&amp;type=printable\">Link to full-text<\/a> [open access - no password required]<\/p>\n<p><strong>Altmetrics:<\/strong><\/p>\n<div class=\"altmetric-embed\" data-badge-details=\"right\" data-badge-type=\"medium-donut\" data-pmid=\"32097440\" data-hide-no-mentions=\"true\"><\/div>\n<p><script type='text\/javascript' src='https:\/\/d1bxh8uas1mnw7.cloudfront.net\/assets\/embed.js'><\/script><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Type of publication: Journal article Author(s): Huibers M.H.W.; van Hensbroek M.B.; Calis J.C.; Bates I.; *McKew S.; Allain T.J.; Phiri C.; Coupland S.E.; Phiri K.S. Citation: PLoS ONE; 2020; vol. 15 (no. 2) Abstract: Background Severe anaemia is a major<span class=\"ellipsis\">&hellip;<\/span><\/p>\n<div class=\"read-more\"><a href=\"https:\/\/www.library.sath.nhs.uk\/research\/2020\/05\/24\/severe-anaemia-complicating-hiv-in-malawi-multiple-co-existing-aetiologies-are-associated-with-high-mortality-2020\/\">Read more <span class=\"screen-reader-text\">Severe anaemia complicating HIV in Malawi; Multiple co-existing aetiologies are associated with high mortality (2020)<\/span><span class=\"meta-nav\"> &#8250;<\/span><\/a><\/div>\n<p><!-- end of .read-more --><\/p>\n","protected":false},"author":12,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"content-type":"","footnotes":""},"categories":[1001,200],"tags":[917,747,1002,903],"class_list":["post-5947","post","type-post","status-publish","format-standard","hentry","category-open-access","category-staff-publication","tag-917","tag-anaemia","tag-gold-open-access","tag-hiv"],"_links":{"self":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/5947","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/comments?post=5947"}],"version-history":[{"count":3,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/5947\/revisions"}],"predecessor-version":[{"id":6583,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/5947\/revisions\/6583"}],"wp:attachment":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/media?parent=5947"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/categories?post=5947"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/tags?post=5947"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}