Treatment for anemia in people with AIDS
Martí-Carvajal AJ, Solà I
Summary
There is a lack of reliable evidence on interventions for treating anemia in persons with HIV infection or AIDS
Persons with HIV infection or AIDS are more likely than the general population to develop anemia, and anemia is the most common blood disorder in the HIV/AIDS infected population. Compared to those who do not develop anemia, HIV-infected individuals who develop anemia are more likely to die early. It is important, therefore, to have good evidence regarding interventions that might be used to treat anemia. This Cochrane review found four randomized trials, all of which investigated recombinant human erythropoietin, which may be beneficial for transfusion requirements, hemoglobin level, and quality of life. All trials were judged to be of poor methodological quality. No data on the effects of recombinant human erythropoietin on death are available from these trials.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews. Copyright © 2009 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This record should be cited as: Martí-Carvajal AJ; Solà I. Treatment for anemia in people with AIDS. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD004776. DOI: 10.1002/14651858.CD004776.pub2.
This version first published online: January 24. 2007
Abstract
Background
Anemia is a common clinical disease in persons with HIV infection and is associated with poor prognosis. There is a need to assess the effects of anemia treatments, and to determine whether these interventions are beneficial.
Objectives
To determine the efficacy and safety of treatments for anemia in people with HIV infection and AIDS.
Search strategy
The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2005), MEDLINE (1980-July 2005), EMBASE (1980-July 2005), LlLACS (1982 to July 2005), reference lists of relevant articles and contact with authors. See Cochrane HIV/AIDS Group search strategy.
Selection criteria
Randomized trials assessing the effects of treatments for anemia in people diagnosed with HIV infection. There were no age restrictions.
Data collection and analysis
Both authors independently assessed relevant studies for inclusion. Data extraction and quality assessment of relevant studies was performed by one author and checked by the other author.
Main results
We included four trials, but focused on the results based on three trials with acceptable attrition rate. None of the trials reported data on death. The two trials that compared recombinant human erythropoietin (rHuEPO) to placebo did not show any benefit on hematological values response, number of patients transfused, or number of packed red cell transfused. One trial compared the effects of two rHuEPO dosing regimens on hemoglobin value and quality of life, but the effects are unclear.
Authors' conclusions
There is a lack of reliable evidence on interventions for treating anemia in patients with HIV infection. This Cochrane review has found some evidence that rHuEPO reduces transfusion requirements, increases hemoglobin levels, and improves quality of life in HIV-infected patients with anemia. However, this is based on evidence from randomized trials with weak or poor methodological quality. There is a need for randomized trials of high methodological quality to evaluate the effect of interventions on anemia in persons infected with human immunodeficiency virus.
