Investigators from the UMass Amherst School of Public Health and Health Sciences have quantified for the first time an increased prevalence of anemia in a community-based sample of people living with HIV/AIDS (PLWHA) in south Asia. In an article titled “HIV Symptom Burden and Anemia among HIV-Positive Individuals: Cross-Sectional Results of a Community-Based Positive Living with HIV (POLH) Study in Nepal”, published by PLOS One, lead author Ms. Catherine Martin, a 2014 graduate from the MPH in Community Health Education program, along with faculty advisor Dr. Krishna Poudel and adjunct faculty member Dr. Kalpana Poudel-Tandukar, report that prevalence of anemia is nearly 70 percent among PLWHA who are in the highest quartile for HIV symptom burden.
Previous research has reported high rates of anemia in PLWHA in hospital or tertiary care settings. The study conducted is the first to describe the prevalence of anemia and associated risk factors, with a specific emphasis on HIV symptom burden, using a community-based sample of HIV-positive people in the Kathmandu Valley, Nepal, a resource-limited country in south Asia.
Studies suggest that PLWHA in developing countries are especially vulnerable to anemia. Anemia can have severe consequences, including fatigue, shortness of breath, and increased heart rate, all of which substantially worsen a patient’s quality of life and can impact HIV disease progression, treatment options, and mortality.
The investigators analyzed baseline data from a longitudinal “Positive Living with HIV” (POLH) study headed by Dr. Poudel. Participants were recruited from five non-governmental organizations working with PLWHA in the Kathmandu Valley, Nepal. Blood samples were collected from 319 PLWHA. The study found an overall rate of 55.8 percent prevalence of anemia in PLWHA in the Kathmandu Valley. As participants’ HIV symptom burden increased, however, the percentage grew to 69.6 percent.
The results indicate that HIV symptom burden is positively correlated with prevalence of anemia. Due to the high prevalence of anemia in this community-based sample of PLWHA, the authors recommend that HIV patients should be counseled on their risk of developing anemia and encouraged to seek timely care for HIV symptoms as described in the Anemia in HIV Working Group guidelines for monitoring and safely treating anemia in PLWHA. These guidelines stress the importance of initiating ART when appropriate, routinely monitoring hemoglobin levels, addressing the correctable causes of anemia (such as malaria, hookworm, malnutrition), and initiating epoetin alfa therapy once correctable causes of anemia have been ruled out.