Prevalence and factors associated with anemia among people living with HIV taking dolutegravir-based antiretroviral therapy at debre markos compressive specialized hospital, debre markos, northwest Ethiopia, 2024: A cross-sectional study
Mohammed Jemal, Hassen Ahmed Yesuf, Mulu Shiferaw Asfaw, Gashaw Abebe, Addis Alem, Zeleke Geto, Altaseb Beyene Kassaw, Adane Adugna, Desalegn Abebaw, Tabarak Malik, Mihiret Bogale Abera, Mohammed Abdu SeidBackground
Anemia is a common hematological complication in people living with HIV (PLHIV), contributing to increased morbidity and mortality. PLHIV are vulnerable to anemia due to chronic inflammation, opportunistic infections, nutritional deficiencies, and the adverse effects of antiretroviral therapy (ART). Despite the favorable safety and efficacy profile of dolutegravir (DTG)–based regimens, emerging evidence has raised concerns about potential hematologic abnormalities, underscoring the need to investigate anemia among PLHIV on DTG-based therapy.
Objective
To assess the prevalence of anemia and its associated factors among PLHIV receiving DTG-based ART at Debre Markos Comprehensive Specialized Hospital (DMCSH) in Northwest Ethiopia.
Design
An institutional-based cross-sectional study.
Methods
This study was conducted among 417 participants enrolled between March 1, 2024, and June 30, 2024, at the ART clinic of DMCSH. Participants were selected using a systematic sampling technique. Socio-demographic data were collected through a structured questionnaire, anthropometric measurements were taken, and clinical data were extracted from patient medical records using a standardized checklist. Hemoglobin levels were measured using the HemoCue® Hb 301 System. The collected data were coded and entered into Epidata version 4.6, then exported to SPSS version 26 for analysis. Logistic regression was conducted to identify factors associated with anemia, with a p-value of < 0.05 considered statistically significant.
Result
The prevalence of anemia among PLHIV on DTG-based ART was 32.6% (95% CI: 28.1, 37.1). Among those diagnosed with anemia, 69.1% had mild anemia, 26.5% had moderate anemia, and 4.4% had severe anemia. Factors significantly associated with anemia included increasing age (AOR = 1.04; 95% CI: 1.02–1.07), female sex (AOR = 1.80; 95% CI: 1.12–2.89), duration of HIV infection ≥ 7 years (AOR = 1.88; 95% CI: 1.10–3.23), CD4 T-cell count < 500 cells/mm 3 (AOR = 1.89; 95% CI: 1.18–3.01), a family history of anemia (AOR = 3.48; 95% CI: 1.63–7.44), and a history of parasitic infection (AOR = 1.83; 95% CI: 1.03–3.27).
Conclusion
Anemia is a moderate public health issue among PLHIV on DTG-based ART. Factors such as female sex, increasing age, duration of HIV infection ≥ 7 years, CD4 T-cell counts < 500 cells/mm 3 , a family history of anemia, and a history of parasitic infections were identified as significant factors of anemia. Thus, routine monitoring of hemoglobin levels is essential, particularly for individuals with one or more of these risk factors, to enable timely intervention when necessary.