ArticleBMJ open2020
Antiretroviral drug class and anaemia risk in the current treatment era among people living with HIV in the USA: a clinical cohort study.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 12 citations in OpenAlex.
- Incidence and correlates of chronic anemia in people living with HIV Initiating ART: An exploratory five-year retrospective cohort of patients retained in care.PLOS global public health · 2026Article
- Low burden of clinically relevant anaemia and thrombocytopenia among adolescents living with HIV receiving tenofovir/lamivudine plus dolutegravir: the CIPHER-ADOLA study in Cameroon.AIDS research and therapy · 2025Article
- Causes and Consequences of Persistent Anemia after 6 Months of Antiretroviral Therapy in Tanzania: An Observational Comparative Cohort Study.The American journal of tropical medicine and hygiene · 2025Observational
- Sex differences in the risk profiles for anemia in people living with HIV, A cross sectional study.PloS one · 2025Article
- The silent epidemic: Tackling the burden of anaemia in Africa.African journal of laboratory medicine · 2025Article
- A Prospective Study of the Medication Regimen Complexity Index and Hospitalization Due to Adverse Drug Reactions Among People Living with HIV.Medicina (Kaunas, Lithuania) · 2024Article
- Review
- Assessment of Gastrointestinal Adverse Effects during the First Six Months of "Biktarvy" Antiretroviral Therapy: Age-Related Patterns and Their Relation with Changes of 5 kg Weight Loss/Gain in the Initial Treatment Period.Diseases (Basel, Switzerland) · 2023Article
- The burden of anemia among Chinese HIV-infected patients following the initiation of antiretroviral therapy in the treat-all era: a nationwide cohort study.BMC infectious diseases · 2023Article
Corrections and comments
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Authors and funding
16 authors at 8 institutions in 1 country.
Funding
Abstract
objectiveAnaemia is common among people living with HIV (PLWH) and has been associated with certain, often older, antiretroviral medications. Information on current antiretroviral therapy (ART) and anaemia is limited. The objective was to compare the associations between anaemia incidence or haemoglobin change with core ART classes in the current ART era.
designRetrospective cohort study.
settingUSA-based prospective clinical cohort of PLWH aged 18 and above receiving care at eight sites between January 2010 and March 2018.
participants16 505 PLWH were included in this study.
main outcome measuresAnaemia risk and haemoglobin change were estimated among PLWH for person-time on a protease inhibitor (PI) or an integrase strand transfer inhibitor (INSTI)-based regimen, relative to a non-nucleoside reverse transcriptase inhibitor (NNRTI)-based reference. We also examined PLWH on regimens containing multiple core classes. Cox proportional hazards regression analyses were conducted to measure the associations between time-updated ART classes and incident anaemia or severe anaemia. Linear mixed effects models were used to examine the relationships between ART classes and haemoglobin change.
resultsDuring a median of 4.9 years of follow-up, 1040 developed anaemia and 488 developed severe anaemia. Compared with NNRTI use, INSTI-based regimens were associated with an increased risk of anaemia (adjusted HR (aHR) 1.26, 95% CI 1.00 to 1.58) and severe anaemia (aHR 1.51, 95% CI 1.07 to 2.11) and a decrease in haemoglobin level. Time on multiple core classes was also associated with increased anaemia risk (aHR 1.39, 95% CI 1.13 to 1.70), while no associations were found for PI use.
conclusionThese findings suggest INSTI use may increase the risk of anaemia. If confirmed, screening for anaemia development in users of INSTIs may be beneficial. Further research into the underlying mechanisms is warranted.
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