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Haemoglobin and albumin as markers of HIV disease progression in the highly active antiretrovial therapy era: relationships with gender *
Author(s) -
Shah S,
Smith CJ,
Lampe F,
Youle M,
Johnson MA,
Phillips AN,
Sabin CA
Publication year - 2007
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2007.00434.x
Subject(s) - medicine , albumin , gastroenterology , confidence interval , serum albumin , antiretroviral therapy , human immunodeficiency virus (hiv) , immunology , viral load
Objectives The aims of the study were to describe gender differences in haemoglobin and albumin and to investigate the prognostic value of these measurements in relation to highly active antiretroviral therapy (HAART). Methods Anaemia was defined as haemoglobin <13.5 g/dL for men and <11.5 g/dL for women. Albumin <35 g/L was defined as hypoalbuminaemia. Proportional hazards models were used to describe relationships between these markers and HIV progression and death. Results A total of 291 patients had pre‐HAART and 1‐year measurements. Mean haemoglobin and albumin levels pre‐HAART were lower in women than in men (haemoglobin: 11.2 vs 13.2 g/dL, respectively, P <0.0001; albumin: 37.4 vs 40.2 g/L, respectively, P <0.0001), and a higher proportion of women were anaemic and hypoalbuminaemic compared with men. Despite a rise in both markers in the first year on HAART, mean haemoglobin levels remained lower by 2.08 g/dL ( P< 0.0001) and albumin by 2.88 g/L ( P< 0.0001) in women. In the 495 patients included in this analysis, haemoglobin and albumin levels were both significantly related to short‐term risk of AIDS and death independently of CD4 count [hazards ratio (HR)=0.73/g/dL higher haemoglobin, 95% confidence interval (CI) 0.55–0.82, P <0.0001 and HR=0.87/g/L higher albumin, 95% CI 0.83–0.91, P <0.0001]. The prognostic value did not differ by gender. Conclusions Women were more likely to be anaemic and/or hypoalbuminaemic pre‐HAART, but post‐HAART increases were similar to those in men. Both haemoglobin and albumin were strong independent prognostic factors for risk of AIDS and death, regardless of gender.