HIV continues to be a major global public health issue, having claimed more than 34 million lives so far. In 2014, 1.2 million people died from HIV-related causes globally. As many as 70-80 % of HIV infected people develop anemia at some stage during the course of infection. Anemia is one of the most common cases of fatigue in people with HIV and if not resolved, associated with shorter survival.
HIV, how is it related to Anemia?
HIV medications, as well as HIV itself, can affect the normal production of red blood cells in the bone marrow, which can result in anemia. Red blood cells develop from erythroid progenitor cells in the bone marrow. HIV associated complications, like Non-Hodgkin's lymphoma cancer, can harm the bone marrow cells. Many drugs used to treat HIV infection or its complications, also have toxic side effects on erythroid progenitor cells that can lead to anemia. The likelihod of developing anemia when these drugs are used increases, as immune function becomes progressively impaired.
Inadequate hormone production may contribute to anemia. The amount of erythropoietin produced by the kidneys may not be enough to stimulate red blood cell production. Adrenal hormones and testosterone, hormones known to stimulate red blood cell production, may also be low in people with HIV. Untreated anemia in HIV disease is associated with an increased risk of death, regardless of cause, and is most likely to occur in people with CD4 cell counts below 200 cells/mm3, especially those who have been diagnosed with an opportunistic infection. CD4 cell count is the most important laboratory indicator of how well the immune system is working and the strongest predictor of HIV progression.
HIV, how is it treated?
Antiretroviral therapy (ART) is recommended for all HIV-infected individuals, regardless of CD4 cell count, to reduce the morbidity, mortality and transmission associated with HIV infection. On a case-by-case basis, ART may be deferred because of clinical and/or psychosocial factors, but therapy should be initiated as soon as possible.
HemoCue in relation to HIV
Hemoglobin levels could be measured easily where resources for laboratory markers such as viral load or even CD4 count are not available. Regular measurements can help to determine which patients are at greatest risk of disease progression, allowing these patients to be identified for closer monitoring or therapeutic intervention.