24104694

PMC4385388

Objective

To assess trends in hemoglobin recovery among HIV-infected patients initiated on zidovudine-based combined antiretroviral therapy (cART) stratified by baseline hemoglobin level.

Methods

Hemoglobin data from non-pregnant adult patients initiating cART in rural north-central Nigeria between June 2009 and May 2011 was analyzed using a linear mixed effects model to assess the interaction between time, zidovudine-containing regimen, and baseline hemoglobin level on the outcome of subsequent hemoglobin level. Best fit curves were created for baseline hemoglobin in the 10th, 25th, 75th and 90th percentiles.

Results

We included 313 patients with 736 measures of hemoglobin in the analysis (239 on zidovudine and 74 on non-zidovudine-containing regimens). Median hemoglobin increased over time in both groups, with differences in hemoglobin response over time related to baseline hemoglobin levels and zidovudine use (p = 0.003). The groups of patients on zidovudine at the 10th and 90th percentiles had downward sloping curves while all other groups had upward trending hemoglobin levels.

Conclusion

Though hemoglobin levels increased overall for patients on zidovudine-containing regimens, for those in the 10th and 90th percentiles hemoglobin levels trended downward over time. These results have implications for decisions regarding when to initiate, switch from or avoid the use of zidovudine.

CDC Public Access

R01 HD075075/HD/NICHD NIH HHS/United States
U2G PS001063/PS/NCHHSTP CDC HHS/United States