Study of aetiology of anemia in HIV positive individuals


  • Umamaheshwari S. Department of General Medicine, Vijayanagar Institute of Medical Sciences, Bellary, Karnataka, India
  • Varun Venkat Raghavan Department of General Medicine, Vijayanagar Institute of Medical Sciences, Bellary, Karnataka, India
  • Ramamurthy P. Department of General Medicine, Vijayanagar Institute of Medical Sciences, Bellary, Karnataka, India
  • Krishna Kumar Naik T. Department of General Medicine, KIMS, Koppal, Karnataka, India



HIV positive, CD4 count, Anemia, MCV, Iron deficiency anemia


Background: HIV/AIDS is a global pandemic. As of 2014, approximately 37 million people have HIV worldwide with the number of new infections that year being about 2 million. This is down from 3.1 million new infections in 2001. The objective of the study was to study the immunological status as indicated by the CD4 count and aetiology of anemia in HIV positive individuals.

Methods: This study was carried out on 100 consecutive HIV patients in the Department of Medicine, Vijayanagara Institute of Medical Sciences Bellary, Karnataka during the period from October 2014 to May 2016.

Results: In this study, 100 patients with HIV infection and anemia were studied to find the etiology of anemia in HIV positive patients Only patients with Hb less than 10 g/dl (moderate to severe grade) were included in this study. 42% patient had moderate grade anemia and 58% had severe grade anemia patient mild grade anemia was excluded. 13 patient had their MCV <76 fl. 60 patient had their MCV between 76-96 fl and 27% had their MCV of >96 fl. 54% of patient had anemia due to chronic disease.

Conclusions: 54% of patient had anemia due to chronic disease, 12% had iron deficiency anemia, 11% had anemia due to vitamin B12 deficiency, 22 % had anemia due to zidovudine induced anemia and 1 patient had anemia due hemolysis.



UNAIDS, WHO. 2007 AIDS epidemic update. 2008.

Volberding PA, Levine AM, Dieterich D, Mildvan D, Mitsuyasu R, Saagand M. Anemia in HIV Working Group Oxford. Journals Medicine & Health Clinical Infectious Diseases. 38(10):1454-63.

Mir N, Costello C, Luckit J, Lindley R. HIV disease and bone marrow changes : a study of 60 cases. Eur J Haematol. 1989;42:339-43.

Kumaraswamy N, Solomon S, Flannigan TP, Hemalatha R, Thyagarajan SP, Mayer KH. Natural history of human immunodeficiency virus disease in southern India. Clin Inf Dis. 2003;36:79-85.

WHO. Hemoglobin concentrations for the diagnosis of anaemia and assessment of severity. 2011.

Meidani M. Prevalence, severity, and related factors of anemia in HIV/AIDS patients. J Res Med Sci. 2012;17(2):138-142.

Medina I, Mills J, Leoung G. Oral therapy for Pneumocystis carinii pneumonia in the acquired immune deficiency syndrome. A controlled trial of trimethopri sulfamethoxazole versus trimethoprim-dapsone. N Engl J Med. 1990;323:776-82.

KIM AH, Jang W, Kim Y, Park YJ, Han K, Oh EJ. Mean Corpuscular Volume (MCV) Values Reflect Therapeutic Effectiveness in Zidovudine‐Receiving HIV Patients. J Clin Lab Anal. 2013;27(5):373-8.

Romanelli F, Empey K, Pomeroy C. AIDS Patient Care STD. 2002;16(9):405-11.

Mugisha JO, Donegan K, Fidler S, Ramjee G, Hodson A, Dunn DT et al. Mean corpuscular volume as a marker for adherence to zidovudine-containing therapy in HIV-infected adults. Open AIDS J. 2012;6:45-52.

Remaca AF, Cadafalch. B12 levels (B12) are often observed in patients infected with human immunodeficiency virus in 18% of patients. J Semin Hematol. 1999 Jan;36(1):75-87.

Balt Ca. AIDS Care. J Assoc Nurses. 2000;11(1):24-8:31-5.

Rule SA, Hooker M, Costello C, Luck W, Hoffbrand AV. Serum vitamin B12 and transcobalamin levels in early HIV disease. Am J Hematol. 1994;47(3):167-71.

Burkes RL, Cohen H, Krailo M, Sinow RM, Carmel R. Low serum cobalamin levels frequently occur in the AIDS and related disorders. Eur J hematology. 1987;38:141-147.

Harriman GR, Smith PD, Horne MK, Fox CH, Koenig S, Lack EE et al. Vitamin B12 malabsorption in patients with acquired immunodeficiency syndrome. Arch Intern Med. 1989;149:2039-41.

Lopez-Caldero, Palacios R, Cobo A, Nuño E, Ruiz J, Márquez M et al. Serum ferritin in HIV-positive patients is related to immune deficiency and inflammatory activity. Int J STD AIDS. 2015;26(6):393-7.

Levin AM, Berhane K, Masri-Lavine L. Prevalence and correlates of anemia in a large cohort of HIV-infected women: Women's Interagency HIV Study. J Acquir Immune Defic Syndr. 2001;26:28-35.

Meidani M, Rezaei F, Maracy MR, Avijgan M, Tayeri K. Prevalence, severity, and related factors of anemia in HIV/AIDS patients. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences. 2012;17(2):138.






Original Research Articles