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Anemia in Human Immunodeficiency Virus Infection: Exploring the Interplay Between Antiretroviral Therapy, Opportunistic Infections, Iron Status, and Anemia

Public Health of Indonesia · Vol. 10 No. 4 (2024) · hlm. 27–37

DOI
10.36685/phi.v10i4.848
ISSN
2477-1570, 2528-1542
Terbit
2024-12-25
Penerbit
YCAB Publisher
Bahasa
eng
Lisensi
creativecommons.org/licenses/by-nc/4.0

Abstrak

Background:Anemia is a prevalent hematological complication among individuals with Human Immunodeficiency Virus (HIV), contributing significantly to increased morbidity and mortality. This study investigates the intricate relationships between antiretroviral therapy (ART), opportunistic infections (OIs), iron metabolism, and anemia in HIV-positive patients in Indonesia. Objective:To elucidate the multifactorial associations among ART regimens, opportunistic infections, iron biochemical parameters, and anemia development in individuals living with HIV. Method:A cross-sectional epidemiological study was conducted at Sulianti Saroso Infectious Disease Hospital, Indonesia, from July to November 2023. The study involved 300 adult HIV-positive patients undergoing ART, with exclusion criteria encompassing pregnant or postpartum individuals, those with recent blood transfusions, and patients with chronic kidney diseases. Data collection included anemia status, ART regimen details, history of opportunistic infections, and iron metabolic profiles (serum iron, total iron-binding capacity [TIBC], and ferritin levels). These were obtained through systematic medical record reviews and laboratory diagnostics. Descriptive statistics, bivariate, and multivariate analyses were employed to explore predictive factors for anemia. Results:The study identified an anemia prevalence of 24.3%, with significantly higher rates among female patients (p = 0.004) and older age groups (p = 0.031). Multivariate regression analysis highlighted critical predictors of anemia: second-line ART (adjusted odds ratio [AOR]: 2.536, p = 0.028), serum iron concentrations (AOR: 0.984, p < 0.001), ferritin levels (AOR: 1.002, p = 0.023), and absolute lymphocyte count (AOR: 0.516, p = 0.003). Conclusion:The findings emphasize the necessity of longitudinal monitoring of hematologic and biochemical parameters to enhance anemia management in HIV-infected populations. The complex interplay between ART regimens, immune status, and iron metabolism underscores the importance of tailored, patient-centered clinical interventions. Keywords:anemia; HIV; antiretroviral therapy; opportunistic infections; iron metabolism

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  • National Research and Innovation Agency
  • Kementerian Kesehatan Republik Indonesia
  • Jenderal Soedirman University
  • Universitas Islam Negeri Ar-Raniry
  • Sumatera Institute of Technology
  • Universitas Negeri Padang
  • Hasanuddin University
  • Organisasi lain
  • Afiliasi tidak diketahui
  • Organisasi berbeda
  • Organisasi sama
  • Afiliasi tidak diketahui
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Rekan penulisOrganisasiArtikel bersama
Jamrud AminuddinJenderal Soedirman University2
Agustina WidiyaniSumatera Institute of Technology2
Nur FarhanahDr. Kariadi Hospital2
Rosamarlina RosamarlinaKementerian Kesehatan Republik Indonesia2
Asep PurnamaAfiliasi tidak diketahui2
Malahayati MalahayatiUniversitas Islam Negeri Ar-Raniry1
Anjar Purba AsmaraUniversitas Islam Negeri Ar-Raniry1
Fitra SaputraUniversitas Islam Negeri Ar-Raniry1
Ida MeutiawatiUniversitas Islam Negeri Ar-Raniry1
Dinda BurhaniUniversitas Islam Negeri Ar-Raniry1
Heru SudrajadNational Research and Innovation Agency1
Ahmad ErlanNational Research and Innovation Agency1
Anton SuryatmaNational Research and Innovation Agency1
Diyan Ermawan EffendiNational Research and Innovation Agency1
A. ArifinHasanuddin University1
Bilalodin BilalodinJenderal Soedirman University1
Mukhtar EffendiJenderal Soedirman University1
Abdullah Nur AzizJenderal Soedirman University1
Pakhrur RaziUniversitas Negeri Padang1
Wihantoro WihantoroJenderal Soedirman University1
Farzand AbdullatifJenderal Soedirman University1
Sunardi SunardiJenderal Soedirman University1
Amir SuudiAfiliasi tidak diketahui1
Ika SaptariniNational Research and Innovation Agency1
SuparmiNational Research and Innovation Agency1
Pandji Wibawa DhewantaraNational Research and Innovation Agency1
RaflizarKementerian Kesehatan Republik Indonesia1
RositaKementerian Kesehatan Republik Indonesia1
OktarinaNational Research and Innovation Agency1
Yuyun YuniarNational Research and Innovation Agency1

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Sumber metadata: OAI-PMH (metadata jurnal) http://stikbar.org/ycabpublisher/index.php/PHI/oai, pertama di-harvest 10 Nov 2026, terakhir terlihat 10 Nov 2026.
Metadata asli (oai_dc) 
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	<dc:title xml:lang="en-US">Anemia in Human Immunodeficiency Virus Infection: Exploring the Interplay Between Antiretroviral Therapy, Opportunistic Infections, Iron Status, and Anemia</dc:title>
	<dc:creator>Murtiani, Farida</dc:creator>
	<dc:creator>Tanjungsari, Dian Wahyu</dc:creator>
	<dc:creator> Shidiq, Achmad</dc:creator>
	<dc:creator>Herlina, Herlina</dc:creator>
	<dc:creator>Dinar Widiantari, Aninda </dc:creator>
	<dc:creator>Nurhayati, Nurhayati</dc:creator>
	<dc:creator>Wirasmi, Sundari </dc:creator>
	<dc:creator>Despitasari, Mieska </dc:creator>
	<dc:creator>Yulianto, Aris </dc:creator>
	<dc:creator> Hendarwan, Harimat</dc:creator>
	<dc:subject xml:lang="en-US">anemia</dc:subject>
	<dc:subject xml:lang="en-US">HIV</dc:subject>
	<dc:subject xml:lang="en-US">antiretroviral therapy (ART)</dc:subject>
	<dc:subject xml:lang="en-US">opportunistic infections</dc:subject>
	<dc:subject xml:lang="en-US">iron status</dc:subject>
	<dc:description xml:lang="en-US">Background:Anemia is a prevalent hematological complication among individuals with Human Immunodeficiency Virus (HIV), contributing significantly to increased morbidity and mortality. This study investigates the intricate relationships between antiretroviral therapy (ART), opportunistic infections (OIs), iron metabolism, and anemia in HIV-positive patients in Indonesia.
Objective:To elucidate the multifactorial associations among ART regimens, opportunistic infections, iron biochemical parameters, and anemia development in individuals living with HIV.
Method:A cross-sectional epidemiological study was conducted at Sulianti Saroso Infectious Disease Hospital, Indonesia, from July to November 2023. The study involved 300 adult HIV-positive patients undergoing ART, with exclusion criteria encompassing pregnant or postpartum individuals, those with recent blood transfusions, and patients with chronic kidney diseases. Data collection included anemia status, ART regimen details, history of opportunistic infections, and iron metabolic profiles (serum iron, total iron-binding capacity [TIBC], and ferritin levels). These were obtained through systematic medical record reviews and laboratory diagnostics. Descriptive statistics, bivariate, and multivariate analyses were employed to explore predictive factors for anemia.
Results:The study identified an anemia prevalence of 24.3%, with significantly higher rates among female patients (p = 0.004) and older age groups (p = 0.031). Multivariate regression analysis highlighted critical predictors of anemia: second-line ART (adjusted odds ratio [AOR]: 2.536, p = 0.028), serum iron concentrations (AOR: 0.984, p &amp;lt; 0.001), ferritin levels (AOR: 1.002, p = 0.023), and absolute lymphocyte count (AOR: 0.516, p = 0.003).
Conclusion:The findings emphasize the necessity of longitudinal monitoring of hematologic and biochemical parameters to enhance anemia management in HIV-infected populations. The complex interplay between ART regimens, immune status, and iron metabolism underscores the importance of tailored, patient-centered clinical interventions.
 Keywords:anemia; HIV; antiretroviral therapy; opportunistic infections; iron metabolism</dc:description>
	<dc:publisher xml:lang="en-US">YCAB Publisher</dc:publisher>
	<dc:date>2024-12-25</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:type xml:lang="en-US">Peer-reviewed Article</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://stikbar.org/ycabpublisher/index.php/PHI/article/view/848</dc:identifier>
	<dc:identifier>10.36685/phi.v10i4.848</dc:identifier>
	<dc:source xml:lang="en-US">Public Health of Indonesia; Vol. 10 No. 4 (2024): October - December; 27 - 37</dc:source>
	<dc:source>2477-1570</dc:source>
	<dc:source>2528-1542</dc:source>
	<dc:source>10.36685/phi.v10i4</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>https://stikbar.org/ycabpublisher/index.php/PHI/article/view/848/371</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2024 Farida Murtiani, Dian Wahyu Tanjungsari, Achmad  Shidiq, Herlina Herlina, Aninda  Dinar Widiantari, Nurhayati Nurhayati, Sundari  Wirasmi, Mieska  Despitasari, Aris  Yulianto, Harimat  Hendarwan</dc:rights>
	<dc:rights xml:lang="en-US">https://creativecommons.org/licenses/by-nc/4.0</dc:rights>
</oai_dc:dc>