Haemoglobin and anaemia in the SMART study.

Abstract

BACKGROUND:

Data from randomized trials on the development of anaemia after interruption of therapy are not well-described.

METHODS:

A total of 2,248 patients from the SMART study were included. We used Cox proportional hazards models to investigate development of new (≤12 mg/dl for females and ≤14 mg/dl for males) or worsening (≤8 mg/dl if anaemic at randomization) anaemia and Poisson regression analyses to explore the relationship between anaemia and the development of AIDS, death or non-AIDS events.

RESULTS:

Overall, 759 patients developed new or worsening anaemia: 420/1,106 (38.0%) in the drug conservation (DC) arm and 339/1127 (30.1%) in the viral suppression (VS) arm (P<0.0001). At 4 months after randomization, patients in the DC arm had a significantly increased risk of developing new or worsening anaemia (adjusted relative hazard 1.56, 95% CI 1.28-1.89). Currently anaemic patients had an increased incidence of AIDS (adjusted incidence rate ratio [IRR] 2.31, 95% CI 1.34-3.98), death (adjusted IRR 2.19, 95% CI 1.23-3.87) and non-AIDS events (adjusted IRR 2.98, 95% CI 2.01-4.40) compared to non-anaemic patients.

CONCLUSIONS:

Patients who interrupted combination antiretroviral therapy had a higher risk of new or worsening anaemia. Anaemic patients had a higher incidence of AIDS, non-AIDS defining events or deaths, possibly due to deteriorating health and subclinical disease.

• Authors: Amanda Mocroft, Alan R Lifson, Giota Touloumi, Jacqueline Neuhaus, Zoe Fox, Adrian Palfreeman, Michael J Vjecha, Sally Hodder, Stephane De Wit, Jens D Lundgren, Andrew N Phillips, INSIGHT SMART Study Group
• Journal: Antiviral therapy (Antivir Ther) Vol. 16 Issue 3 Pg. 329-37 ( 2011) ISSN: 2040-2058 [Electronic] England
• PMID: 21555815 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)

Chemical References

• Anti-HIV Agents
• Hemoglobins
• Reverse Transcriptase Inhibitors

Topics

• Acquired Immunodeficiency Syndrome (epidemiology, mortality, virology)
• Adult
• Anemia (epidemiology, mortality, physiopathology)
• Anti-HIV Agents (administration & dosage, therapeutic use)
• CD4 Lymphocyte Count
• Drug Administration Schedule
• Female
• HIV Infections (drug therapy, epidemiology, mortality)
• Hemoglobins (analysis)
• Humans
• Incidence
• Male
• Middle Aged
• Prognosis
• Proportional Hazards Models
• Reverse Transcriptase Inhibitors (administration & dosage, therapeutic use)
• Risk
• Risk Factors