Premium
Anemia in TB patients predicts recurrence and mortality
Author(s) -
Isanaka Sheila,
Mugusi Ferdinand,
Urassa Willy,
Bosch Ronald J.,
Villamor Eduardo,
Spiegelman Donna,
Duggan Christopher,
Fawzi Wafaie
Publication year - 2011
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.25.1_supplement.779.14
Subject(s) - medicine , anemia
We aimed to prospectively relate repeated measures of anemia and hypochromic microcytosis, an erythrocyte characteristic consistent with iron deficiency, to the risk of treatment failure, tuberculosis (TB) recurrence and mortality among HIV+ and HIV‐ TB patients. We observed no evidence for an association between anemia (hemoglobin (Hb) < 11 g/dl) or hypochromic microcytosis and the risk of treatment failure at 1 month. Among HIV+ patients, time‐updated anemia was associated with a 4‐fold increased risk of recurrence (adjusted HR = 4.00, 95% CI: 1.55, 10.31), but there was no evidence for an association among HIV‐ patients. Moderate (Hb 8.5 to < 11.0 g/dL) and severe (Hb < 8.5 g/dL) anemia were associated with independent 2 and 3‐fold increases in risk in mortality (adjusted HR for moderate anemia = 2.39, 95% CI: 1.47, 3.91 and adjusted HR for severe anemia = 3.18, 95% CI: 1.67, 6.05). Adjustment for hypochromic microcytosis had no appreciable influence on the observed increased risks associated with anemia. Our evidence suggests that causes of anemia other than iron deficiency may be important in this population. An understanding of the risk factors for poor clinical outcomes in TB, including anemia, should motivate more focused management of selected patients and may result in significant improvements in their overall health and survival. This research was supported by NIAID grant U01AI045441.