Effect of Zidovudine on Hematological and Virologic Parameters among Female Sex Workers Receiving Antiretroviral Therapy (ART) in North – Western Nigeria
Hemoglobin (HB) indicates anemia level and by
extension may reflect the nutritional level and perhaps the immunity
of an individual. Some antiretroviral drugs like Zidovudine are
known to cause anemia in people living with HIV/AIDS (PLWHA).
A cross sectional study using demographic data and blood specimen
from 218 female commercial sex workers attending antiretroviral
therapy (ART) clinics was conducted between December, 2009 and
July, 2011 to assess the effect of zidovudine on hematologic, and
RNA viral load of female sex workers receiving antiretroviral
treatment in north western Nigeria. Anemia is a common and serious
complication of both HIV infection and its treatment. In the setting of
HIV infection, anemia has been associated with decreased quality of
life, functional status, and survival. Antiretroviral therapy,
particularly the highly active antiretroviral therapy (HAART), has
been associated with a decrease in the incidence and severity of
anemia in HIV-infected patients who have received a HAART
regimen for at least 1 year. In this study, result has shown that of the
218 patients, 26 with hemoglobin count between 5.1 – 10g/dl were
observed to have the highest viral load count of 300,000 –
350,000copies/ml. It was also observed that most patients (190) with
HB of 10.1 – 15.0g/dl had viral load count of 200,000 – 250,000
copies /ml. An inverse relationship therefore exists i.e. the lower the
hemoglobin level, the higher the viral load count even though the test
statistics did not show any significance between the two (P = 0.206).
This shows that multivariate logistic regression analysis
demonstrated that anemia was associated with a CD4 + cell count
below 50/μL, female sex workers with a viral load above 100,000
copies/mL, who use zidovudine.
Severe anemia was less prevalent in this study population than in
historical comparators; however, mild to moderate anemia rates
remain high. The study therefore recommends that hematological and
virologic parameters be monitored closely in patients receiving first
line ART regimen.
[1] UNAIDS AIDS Epidemic Update. Geneva, December; 2005.
[2] Karim A. Q., Karim S. S. A., Soldan., Zondi M. Reducing the risk of
HIV infection among South African Sex workers – Socio economic and
gender barriers. Am J. Public Health, 1995; 1521 – 1525.
[3] Davis C., Heath A., Best S. Calibration of HIV -1 working reagents for
nucleic acid amplification techniques against the 1st international
standard for HIV -1 RNA. Journal of Virological Methods, 2003; 107:
37 – 44
[4] Deeks S. G., Hecht F. M., Swanson M., Elbeik T., Loftus R., Cohen P.
T. HIV RNA and CD4 Cell Count Response to Protease Inhibitor
Therapy in an Urban AIDS Clinic: Response to Both Initial and Salvage
Therapy, AIDS, 1999; 13(6):35–43.
[5] Federal Ministry of Health National seroprevalence Surveillance sentinel
survey among pregnant women attending antenatal clinics in Nigeria.
Abuja, Nigeria: Department of Public Health, 2010.
[6] Hecht, F.M. Bush M. P., Rawul B., Webb M., Rosenberg E., Swanson
M. Use of laboratory tests and clinical symptoms for identification of
primary HIV infection. AIDS, 2002; 16:1119 – 1129.
[7] Moore RD. Human immunodeficiency virus infection, anemia, and
survival Clinical Infectious Diseases. 1999; 29: 44-49. [8] Myers TW, Gelfand DH. Reverse transcription and DNA amplification
by a Thermus thermophilus DNA polymerase. Biochem, 1991; 30:7661 -
6.
[9] National AIDS and STD control program technical report of the 2005
National HIV/Syphilis sero – prevalence sentinel survey among
pregnant women attending antenatal clinics in Nigeria (2005): technical
report.
[10] Yen – Livermann B., Brambilla D., Jackson B. Evaluation of a quality
assuarance program for quantification of human immunodeficiency virus
type 1 RNA in plasma by the AIDS clinical trials group virology
laboratories. J Clinical Microbiology, 1996; 34: 2695 – 701.
[11] World Health Organization Manual for HIV Drug Resistance Testing
using Dried Blood Spot specimens. http://www.who.int/hiv/tropics/drug
resistance/dbs_ protocol accessed 2010.
[12] Holmes H., Davis C., Heath A., Best S., An international collaborative
study to establish the 1st international standard for HIV – 1 RNA` for
use in nucleic acid – based techniques. J Virol Methods, 2001; 92; 141 –
50.
[13] Davis C., Heath A., Best S.Caliberation of HIV -1 working reagents for
nucleic acid amplification techniques against the 1st international
standard for HIV-1 RNA. J Virol Meth. 2003 ; 107 : 37 – 44
[14] Louis Saccabarrozi.Sexworkers and HIV. The ‘body’ http://www.the
body.com/content/art 14140 html. 2007; 1 – 4.
[15] Katlama, C. Ingrand D., Love day C. Safety and eficacy of Lamivudine
– Zidovudine combination therapy in antiretroviral naive patients. A
randomized controlled comparison with Zidovudine monotherapy.
Lamivudine European HIV working Group. J Am Med
[1] UNAIDS AIDS Epidemic Update. Geneva, December; 2005.
[2] Karim A. Q., Karim S. S. A., Soldan., Zondi M. Reducing the risk of
HIV infection among South African Sex workers – Socio economic and
gender barriers. Am J. Public Health, 1995; 1521 – 1525.
[3] Davis C., Heath A., Best S. Calibration of HIV -1 working reagents for
nucleic acid amplification techniques against the 1st international
standard for HIV -1 RNA. Journal of Virological Methods, 2003; 107:
37 – 44
[4] Deeks S. G., Hecht F. M., Swanson M., Elbeik T., Loftus R., Cohen P.
T. HIV RNA and CD4 Cell Count Response to Protease Inhibitor
Therapy in an Urban AIDS Clinic: Response to Both Initial and Salvage
Therapy, AIDS, 1999; 13(6):35–43.
[5] Federal Ministry of Health National seroprevalence Surveillance sentinel
survey among pregnant women attending antenatal clinics in Nigeria.
Abuja, Nigeria: Department of Public Health, 2010.
[6] Hecht, F.M. Bush M. P., Rawul B., Webb M., Rosenberg E., Swanson
M. Use of laboratory tests and clinical symptoms for identification of
primary HIV infection. AIDS, 2002; 16:1119 – 1129.
[7] Moore RD. Human immunodeficiency virus infection, anemia, and
survival Clinical Infectious Diseases. 1999; 29: 44-49. [8] Myers TW, Gelfand DH. Reverse transcription and DNA amplification
by a Thermus thermophilus DNA polymerase. Biochem, 1991; 30:7661 -
6.
[9] National AIDS and STD control program technical report of the 2005
National HIV/Syphilis sero – prevalence sentinel survey among
pregnant women attending antenatal clinics in Nigeria (2005): technical
report.
[10] Yen – Livermann B., Brambilla D., Jackson B. Evaluation of a quality
assuarance program for quantification of human immunodeficiency virus
type 1 RNA in plasma by the AIDS clinical trials group virology
laboratories. J Clinical Microbiology, 1996; 34: 2695 – 701.
[11] World Health Organization Manual for HIV Drug Resistance Testing
using Dried Blood Spot specimens. http://www.who.int/hiv/tropics/drug
resistance/dbs_ protocol accessed 2010.
[12] Holmes H., Davis C., Heath A., Best S., An international collaborative
study to establish the 1st international standard for HIV – 1 RNA` for
use in nucleic acid – based techniques. J Virol Methods, 2001; 92; 141 –
50.
[13] Davis C., Heath A., Best S.Caliberation of HIV -1 working reagents for
nucleic acid amplification techniques against the 1st international
standard for HIV-1 RNA. J Virol Meth. 2003 ; 107 : 37 – 44
[14] Louis Saccabarrozi.Sexworkers and HIV. The ‘body’ http://www.the
body.com/content/art 14140 html. 2007; 1 – 4.
[15] Katlama, C. Ingrand D., Love day C. Safety and eficacy of Lamivudine
– Zidovudine combination therapy in antiretroviral naive patients. A
randomized controlled comparison with Zidovudine monotherapy.
Lamivudine European HIV working Group. J Am Med
@article{"International Journal of Medical, Medicine and Health Sciences:70334", author = "N. M. Sani and E. D. Jatau and O. S. Olonitola and M. Y. Gwarzo and P. Moodley and N. S. Mujahid", title = "Effect of Zidovudine on Hematological and Virologic Parameters among Female Sex Workers Receiving Antiretroviral Therapy (ART) in North – Western Nigeria", abstract = "Hemoglobin (HB) indicates anemia level and by
extension may reflect the nutritional level and perhaps the immunity
of an individual. Some antiretroviral drugs like Zidovudine are
known to cause anemia in people living with HIV/AIDS (PLWHA).
A cross sectional study using demographic data and blood specimen
from 218 female commercial sex workers attending antiretroviral
therapy (ART) clinics was conducted between December, 2009 and
July, 2011 to assess the effect of zidovudine on hematologic, and
RNA viral load of female sex workers receiving antiretroviral
treatment in north western Nigeria. Anemia is a common and serious
complication of both HIV infection and its treatment. In the setting of
HIV infection, anemia has been associated with decreased quality of
life, functional status, and survival. Antiretroviral therapy,
particularly the highly active antiretroviral therapy (HAART), has
been associated with a decrease in the incidence and severity of
anemia in HIV-infected patients who have received a HAART
regimen for at least 1 year. In this study, result has shown that of the
218 patients, 26 with hemoglobin count between 5.1 – 10g/dl were
observed to have the highest viral load count of 300,000 –
350,000copies/ml. It was also observed that most patients (190) with
HB of 10.1 – 15.0g/dl had viral load count of 200,000 – 250,000
copies /ml. An inverse relationship therefore exists i.e. the lower the
hemoglobin level, the higher the viral load count even though the test
statistics did not show any significance between the two (P = 0.206).
This shows that multivariate logistic regression analysis
demonstrated that anemia was associated with a CD4 + cell count
below 50/μL, female sex workers with a viral load above 100,000
copies/mL, who use zidovudine.
Severe anemia was less prevalent in this study population than in
historical comparators; however, mild to moderate anemia rates
remain high. The study therefore recommends that hematological and
virologic parameters be monitored closely in patients receiving first
line ART regimen.", keywords = "Female sex worker, Zidovudine, Hemoglobin,
Anemia.", volume = "9", number = "5", pages = "456-6", }