ANEMIA & HIV

What is anemia?
Anemia is a below-normal level of hemoglobin* or hematocrit*. Hemoglobin is the protein
in red blood cells that carries oxygen to all parts of the body.
How common is anemia in people with HIV/AIDS?
It has been estimated that up to 95% of people infected with HIV will experience anemia
at some point.
The incidence of anemia ranges from 10% in people who have no symptoms to 92% in
individuals with advanced aids.
What causes anemia in people with HIV/AIDS?
 Normal progression of the disease. The virus can infect parts of the bone marrow
responsible for the production of rbcs.
 Deficiency of erythropoeitin.
 Autoimmune destruction of blood cells
 Opportunistic infection such as mycobacterial and fungal diseases.
 Cancers of bone marrow such as non-hodgkins lymphoma.
 Nutritional deficiencies.
 Bleeding.
Risk Factors for developing Anemia.
 Lower cd4 cell counts.
 Higher viral load.
 Taking zidovudine.
 Being a woman.
What are the effects of untreated anemia in HIV/AIDS?
 Fatigue and other symptoms associated with anemia can interfere with daily
activities.
 Anemia also increases the chance that HIV infection will progress to AIDS 5 times
faster than normal.
 Studies show people with HIV and those with AIDS who are anemic have a shorter
life expectancy than people without anemia.
 Poor quality of life.
 Reduced adherence to medications.
 Risk for cardiac complications.
How do We know if a Patient develops anemia?
The best way to determine if a patient has anemia is changes in hemoglobin and
Hematocrit levels*. Other symptoms can include fatigue, pale skin, tachycardia dyspnea,
dizziness, irritability, coldness of hands and feet, and headache.
What treatment options are available?
 Finding out the cause for anemia and its elimination. For example, If a patient’s
anemia is associated with Zidovudine therapy, an alternate drug is considered.
 Vitamin supplements if it is associated with vitamin deficiency.
 Severe anemia may need a blood transfusion. But, transfusions are avoided
because of the increased risk of opportunistic infections and death.
 Erythropoietin which stimulates the production of red blood cells has been approved
for treating anemia in HIV/AIDS. It reduces the need for blood transfusions, improve
energy levels and overall improvement in quality of life.
Nursing Management
To Manage the Activity Intolerance
 Monitor Cardio respiratory response to activity
 Limit patient’s activity and assist with regular physical activities.
 Encourage alternate rest and activity periods
 Plan activity for periods when patient has the most energy and educate on energy
saving techniques.
 Provision of oxygen supplementation according to the physician’s instruction.
To Improve Dietary Intake
 Plan with dietician the number of calories and type of nutrients needed.
 Encourage increased intake of protein, iron and vitamin-c resources.
 Encourage small frequent feeds and to add flavor such as salt, sugar or lemon.
 Educate the patient about maintaining the food diary and monitor the recorded
intake for nutritional contents.
 Provide health education regarding easily available foods rich in nutrition.
 Provide supplementary medications as prescribed by the physician.
To Improve the Medication Compliance
 Identify the patient knowledge regarding the medication regime.
 Instruct the patient on the purpose and action of each medication.
 Instruct the patient on possible adverse reactions of the drugs and to approach
health care professionals if it occurs.
 Educate the patient about the ill effects of stopping the drugs without the physician’s
advice.
 Provide counseling and handout in their language on discharge regarding drug
intake for future reference of the patient.

*Normal Lab Values: Normal hemoglobin >12 g/dL for women, >14 g/dL for men;
normal hematocrit >36% for women, >42% for men.