Abstract:
BACKGROUND፡ Although injection substance users and
individuals co-infected with Human Immunodeficiency
Virus-1 and Mycobacterium tuberculosis suffer marked
hematologic derangements, the rates, levels, morphologic
types and associated risk factors of anemia among Human
immunodeficiency virus and Mycobacterium tuberculosis co
infected injection substance users has not been reported in
Kenya.
METHODS: This cross-sectional study determined anemia
rates, levels and morphologic types. Anemia was associated
with
clinical
markers
of
disease-
underweight,
immunosuppression and viral load. Complete blood count,
CD4 T-cell enumeration and viral load were determined via
standard laboratory methods.
RESULTS: All injection substance users had higher rates of
anaemia (HIV+TB+ ISUs, 79.3%; HIV-TB+ISUs, 70.0%;
HIV+TB- ISUs, 56.6% and HIV-TB- ISUs, 56.2%) relative to
non-ISUs (16.6%; P<0.05). A significant proportion of
HIV+TB+ISUs (47.8%) developed severe anemia than other
clinical groups. The commonest morphologic type of anemia
in HIV+TB+ISUs was microcytic hypochromic (43.5%)
followed by normocytic hypochromic (17.4%) relative to the
other clinical groups. HIV+TB+ ISUs with CD4 T-cells
<200/uL (OR: 2.94, 95% CI: 1.41-6.13, P=0.004) and CD4 T
cells of 200-349/uL (OR: 3.24, 95% CI: 1.66-6.31, P=0.001)
associated with higher odds of developing anemia.
CONCLUSION: This study revealed that severe anemia and
microcytic hypochromic anemia are the most common
erythrocytic sequelae among Human Immunodeficiency
Virus-1 and Mycobacterium tuberculosis co-infected ISUs.
Those with CD4 T-cells < 350/uL are utmost expected to
develop anemia.
KEYWORDS: Injection substance users, Human
Immunodeficiency Virus-1, Mycobacterium tuberculosis,
anemia
