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Objective To investigate the influencing factors of anemia and anemia exacerbation in people living with HIV/AIDS (PLWHA) during antiretroviral therapy (ART), as well as the impact of anemia on the prognosis of PLWHA. Methods This retrospective cohort study collected baseline and follow-up data for PLHIV who initiated ART at a specialized infectious-disease hospital in Guangzhou from February 10, 2004 to March 29, 2019. A generalized linear mixed-effects model was used to analyze the factors influencing anemia during long-term ART in PLWHA without anemia at baseline. The Cox proportional hazards model was used to analyze both the influencing factors of anemia exacerbation in those with baseline anemia and the impact of baseline anemia and follow-up anemia on the prognosis. Results There were 11 688 PLWHA, of whom 3 853(32.97%) had anemia at baseline. Among 7 835 PLWHA without anemia at baseline, 1 695 (21.63%) developed anemia during the follow-up. Among 3 470 PLWHA with mild or moderate anemia at baseline, 845 (24.35%) had anemia exacerbation during the follow-up. Risk factors for follow-up anemia in PLWHA included being female, aged ≥50 years at ART initiation, being married/cohabiting, being divorced/separated/widowed, blood transmission, baseline opportunistic infections, higher number of baseline clinical symptoms, the initial ART regimen containing Zidovudine (AZT), CD4 cell count <200 cells/μL, and abnormal serum creatinine. Risk factors for anemia exacerbation included being female, being married/cohabiting, being divorced/separated/widowed, an interval of ≥6 months from diagnosis to ART initiation, ≥2 categories of baseline clinical symptoms, an initial ART regimen containing AZT, and abnormal serum creatinine. The risk of death in PLWHA without anemia at baseline but developing anemia during the follow-up was 5.02 times (95% CI: 2.45-10.27) than that among those without anemia at both baseline and during the follow-up. The risk of death with anemia at both baseline and during the follow-up was 6.00 times (95%CI: 3.04-11.85) than that among those without anemia at both baseline and during the follow-up. Conclusion Follow-up anemia and anemia exacerbation during ART are affected by multiple factors. Baseline anemia and follow-up anemia are important risk factors for the prognosis of PLWHA. Anemia screening for high-risk groups should be strengthened to strive for early detection, early diagnosis, and early treatment, thereby reducing the risk of death of PLWHA.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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