Table 2. Distribution and multivariate analysis of co-existing factors associated with severe (Hb≤ 70 g/l- Hb> 50 g/l) and very severe anaemia (Hb≤ 50 g/l) in HIV-infected adults in Malawi.
| Overall N = 199(100%) | Severe anaemia N = 115/199 (57.8%) |
Very severe anaemia N = 84/199 (42.2%) |
Univariate | Multivariate | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Odds | 95% -CI | P-value | Odds | 95% -CI | P-value | |||||
| Sex (female) | 129 (64.8%) | 74/115 (65.2%) | 55/84 (65.4%) | 1.1 | 0.6–1.9 | 0.869 | - | - | - | |
| HIV | ||||||||||
| CD4 ≤200 cells/mm3 | 104/155 (67.1%) | 62/87 (71.3%) | 42/68 (61.8%) | 1.04 | 0.6–1.8 | 0.889 | - | - | - | |
| Viral load ≥1000 copies/ml | 136/184 (73.9%) | 81/104 (77.9%) | 55/80 (68.8%) | 0.6 | 0.3–1.2 | 0.163 | - | - | - | |
| On ART at enrolment | 91/199 (42.7%) | 52/115 (40.9%) | 39/84 (45.2%) | 1.1 | 0.6–1.8 | 0.865 | - | - | - | |
| Infection | ||||||||||
| Malaria | 6/167 (1%) | 3/100 (3.0%) | 3/67 (4.5%) | 1.5 | 0.3–7.8 | 0.617 | - | - | - | |
| Tuberculosis | 82/199 (41.2%) | 53/115 (46.0%) | 29/84 (34.5%) | 0.7 | 0.6–0.99 | 0.043 | 0.6 | 0.1–2.8 | 0.507 | |
| Bacteraemia1 | 26/199 (13.1%) | 17/115 (61.7%) | 9/82 (11.0%) | 0.7 | 0.3–1.6 | 0.402 | - | - | - | |
| Parvovirus B19 | 7/170 (4.2%) | 5/99 (5.0%) | 2/71 (2.8%) | 0.5 | 0.1–2.9 | 0.476 | - | |||
| Cytomegalovirus (CMV) | 57/170 (33.5%) | 28/99 (28.3%) | 29/71 (40.8%) | 1.8 | 0.9–3.3 | 0.088 | - | - | ||
| Epstein-Barr virus (EBV) | 69/170 (40.6%) | 40/99 (40.4%) | 29/71 (40.8%) | 1.0 | 0.6–1.9 | 0.954 | - | - | - | |
| EBV/CMV co-infection | 28/170 (16.5%) | 12/99 (12.1%) | 16/71 (22.5%) | 2.1 | 0.9–4.5 | 0.075 | 2.8 | 1.2–7.0 | 0.024 | |
| Malnutrition | ||||||||||
| Underweight | 74/148 (49.7%) | 40/81 (49.3%) | 34/68 (50.0%) | 1.0 | 0.5–2.0 | 0.940 | - | - | - | |
| Vitamin B12 deficiency | 2/194 (1.0%) | 1/113 (0.8%) | 1/81 (1.2%) | 1.4 | 0.09–22.7 | 0.813 | - | - | - | |
| MCV ≤ 83 fl2 | 61/180 (33.9%) | 38/104 (36.5%) | 23/76 (30.3%) | 0.8 | 0.40–1.42 | 0.380 | - | - | - | |
| Folate deficiency | 23/194 (11.9%) | 13/113 (11.5%) | 10/84 (11.9%) | 1.1 | 0.5–2.6 | 0.858 | - | - | - | |
| Medication | ||||||||||
| Cotrimoxazole | 163/199 (81.9%) | 99/115 (81.6%) | 64/84 (76.2%) | 0.5 | 0.3–2.3 | 0.076 | 0.5 | 0.2–1.2 | 0.120 | |
| Zidovudine | 13/199 (6.5%) | 5/50 (10.0%) | 8/40 (20.0%) | 2.3 | 0.7–7.5 | 0.187 | - | - | - | |
| Renal function | ||||||||||
| Impaired (GFR 15–60) | 24/185 (13.0%) | 12/105 (11.4%) | 12/80 (15.0%) | 1.5 | 0.6–3.6 | 0.339 | ||||
| End stage (GFR ≤15) | 12/185 (6.5%) | 3/105 (2.9%) | 9/80 (11.3%) | 4.6 | 1.2–17.6 | 0.027 | 4.0 | 0.9–16.8 | 0.061 | |
| Bone marrow | ||||||||||
| Bone marrow disease | 28/71 (39.4%) | 19/42 (45.2%) | 9/29 (31.0%) | 0.5 | 0.2–1.5 | 0.231 | - | - | ||
| Aetiology | ||||||||||
| Co-existing aetiologies per patient (mean, SD) | 3.3 (1.3) | 3.3 (1.2) | 3.2 (1.4) | 0.8 | 0.4–1.8 | 0.605 | - | - | - | |
1 A total of 28-blood cultures were positive, the most common organisms were E. coli (42.9%; 12/28) and non-Typhoid Salmonella (17.9%; 5/28). 2 Iron deficiency was defined by MCV≤ 83 fl. Explanatory variables associated with the outcome variables (P > 0.10) in the univariable analysis were excluded in the multivariable model in a stepwise approach (-). Abbreviation: GFR; Glomerular filtration rate.