Anemia and iron supplementation in relation to viral load and mortality among 70,442 people living with HIV in Tanzania.
HIV
anemia
iron supplement use
mortality
viral load
Journal
The Journal of nutrition
ISSN: 1541-6100
Titre abrégé: J Nutr
Pays: United States
ID NLM: 0404243
Informations de publication
Date de publication:
12 Apr 2024
12 Apr 2024
Historique:
received:
27
01
2024
revised:
02
04
2024
accepted:
10
04
2024
medline:
15
4
2024
pubmed:
15
4
2024
entrez:
14
4
2024
Statut:
aheadofprint
Résumé
Anemia may be associated with poor clinical outcomes among people living with HIV (PLHIV) despite highly active antiretroviral therapy (HAART). There are concerns that iron supplementation may be unsafe to prevent and treat anemia among PLHIV. We sought to evaluate the associations of anemia and iron supplementation with mortality and viral load among PLHIV in Tanzania. We analyzed data from a cohort of 70,442 non-pregnant adult PLHIV in Tanzania conducted between 2015 and 2019. Regression models evaluated the relationships between anemia severity and iron supplement use with mortality, and unsuppressed HIV-1 viral load among all participants and stratified by whether participants were initiating or continuing HAART. Anemia was associated with an increased risk of mortality and unsuppressed viral load for participants who initiated or continued HAART. Iron supplement use was associated with reduced mortality risk but also had a greater risk of an unsuppressed viral load among participants continuing HAART. There was no association of iron supplement use with mortality, and unsuppressed viral load among PLHIV that were initiating HAART. There was a stronger negative association of iron supplement use with the risk of having an unsuppressed viral load among participants with Stage III/IV disease compared to Stage I/II disease. Anemia was associated with increased risk of mortality and unsuppressed viral load but the benefits and safety of iron supplements appear to differ for those initiating as compared to continuing ART as well as by HIV disease severity.
Sections du résumé
BACKGROUND
BACKGROUND
Anemia may be associated with poor clinical outcomes among people living with HIV (PLHIV) despite highly active antiretroviral therapy (HAART). There are concerns that iron supplementation may be unsafe to prevent and treat anemia among PLHIV. We sought to evaluate the associations of anemia and iron supplementation with mortality and viral load among PLHIV in Tanzania.
METHODS
METHODS
We analyzed data from a cohort of 70,442 non-pregnant adult PLHIV in Tanzania conducted between 2015 and 2019. Regression models evaluated the relationships between anemia severity and iron supplement use with mortality, and unsuppressed HIV-1 viral load among all participants and stratified by whether participants were initiating or continuing HAART.
RESULTS
RESULTS
Anemia was associated with an increased risk of mortality and unsuppressed viral load for participants who initiated or continued HAART. Iron supplement use was associated with reduced mortality risk but also had a greater risk of an unsuppressed viral load among participants continuing HAART. There was no association of iron supplement use with mortality, and unsuppressed viral load among PLHIV that were initiating HAART. There was a stronger negative association of iron supplement use with the risk of having an unsuppressed viral load among participants with Stage III/IV disease compared to Stage I/II disease.
CONCLUSION
CONCLUSIONS
Anemia was associated with increased risk of mortality and unsuppressed viral load but the benefits and safety of iron supplements appear to differ for those initiating as compared to continuing ART as well as by HIV disease severity.
Identifiants
pubmed: 38615735
pii: S0022-3166(24)00222-0
doi: 10.1016/j.tjnut.2024.04.019
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024. Published by Elsevier Inc.
Déclaration de conflit d'intérêts
Declaration of Competing Interest ☒ The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.