Anemia
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CLINICAL
- Prevalence 1-10% in asymptomatic HIV, 10-25% with CD4-defined AIDS, 30-60% with AIDS-defining illness
- Hypoproliferative anemia more common than hemolytic anemia
- Earliest Sx affect functional status: easy fatigue, weakness, exertional dyspnea, slowed cognition (Hgb < 10-11)
- Later Sx include rapid heart rate, bounding pulse, dyspnea, severe fatigue, confusion, angina, CHF (Hbg < 8-9)
- HIV can directly cause suppression of hematopoietic precursor cells in marrow through inflammatory cytokine suppression, inhibition of endogenous erythropoietin response
- Hypogonadism (low testosterone level) can cause anemia.
- Anemia associated with worse survival in HIV, but unlikely causal. May be impaired erythropoiesis from HIV associated chronic inflammation. Hgb independent factor in prognostic indices for mortality and morbidity.
MORE CLINICAL
Cause | Laboratory |
Decreased RBC Production | Reticulocyte count low |
Ineffective RBC Production | Reticulocyte count low |
RBC Destruction (Hemolysis) | Reticulocyte count high |
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CLINICAL
- Prevalence 1-10% in asymptomatic HIV, 10-25% with CD4-defined AIDS, 30-60% with AIDS-defining illness
- Hypoproliferative anemia more common than hemolytic anemia
- Earliest Sx affect functional status: easy fatigue, weakness, exertional dyspnea, slowed cognition (Hgb < 10-11)
- Later Sx include rapid heart rate, bounding pulse, dyspnea, severe fatigue, confusion, angina, CHF (Hbg < 8-9)
- HIV can directly cause suppression of hematopoietic precursor cells in marrow through inflammatory cytokine suppression, inhibition of endogenous erythropoietin response
- Hypogonadism (low testosterone level) can cause anemia.
- Anemia associated with worse survival in HIV, but unlikely causal. May be impaired erythropoiesis from HIV associated chronic inflammation. Hgb independent factor in prognostic indices for mortality and morbidity.
MORE CLINICAL
Cause | Laboratory |
Decreased RBC Production | Reticulocyte count low |
Ineffective RBC Production | Reticulocyte count low |
RBC Destruction (Hemolysis) | Reticulocyte count high |
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