Anemia is independently associated with mortality in people living with human immunodeficiency virus/acquired immune deficiency syndrome: A propensity score matching-based retrospective cohort study in China
Although previous studies have suggested that hemoglobin is related to the health status of people living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) (PLWHA), the role of anemia in mortality remains unclear. This study aimed to comprehensively quantify the effect...
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1055115/full |
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| author | Meihua Jin Yanan Wang Yanan Wang Yanan Wang Jing Li Zhenqian Wu Xiaoqi Liu Hui Wang Hui Wang Yuxin Chen Yuxin Chen Ziyi Wang Ziyi Wang Zhaowei Tong Xiaofeng Li Feilin Ren Xiaojuan Zhu Zhongrong Yang Guangyun Mao Guangyun Mao Guangyun Mao |
| author_facet | Meihua Jin Yanan Wang Yanan Wang Yanan Wang Jing Li Zhenqian Wu Xiaoqi Liu Hui Wang Hui Wang Yuxin Chen Yuxin Chen Ziyi Wang Ziyi Wang Zhaowei Tong Xiaofeng Li Feilin Ren Xiaojuan Zhu Zhongrong Yang Guangyun Mao Guangyun Mao Guangyun Mao |
| author_sort | Meihua Jin |
| collection | DOAJ |
| description | Although previous studies have suggested that hemoglobin is related to the health status of people living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) (PLWHA), the role of anemia in mortality remains unclear. This study aimed to comprehensively quantify the effect of anemia on the mortality risk of PLWHA. In this retrospective cohort study, we thoroughly estimated the effect of anemia on PLWHA mortality, using data collected from January 2005 to June 2022 in the Huzhou area, in 450 subjects extracted from the database of the China Disease Prevention and Control Information System and matched them using a propensity score matching approach to balance potential confounding bias. The potential exposure–response relationship between anemia, hemoglobin concentration, and the mortality of PLWHA was also carefully estimated. A series of subgroup analyses, including interaction analysis, was further conducted to validate the robustness of the effect of anemia on PLWHA death risk. Anemia was significantly associated with an elevated death risk in PLWHA, with an increase of 74% (adjusted hazard ratio [AHR]: 1.74; 95% confidence interval [CI]: 1.03–2.93; p = 0.038) in those with anemia after adjusting for potential confounders. PLWHA with moderate or severe anemia had a higher risk of death, with an 86% increase (AHR = 1.86; 95% CI: 1.01–3.42; p = 0.045). Meanwhile, the AHR tended to increase by 85% on average (AHR = 1.85, 95% CI: 1.37–2.50; p < 0.001) with a per standard deviation (SD) decrease in plasma hemoglobin. Consistent relationships between plasma hemoglobin and the risk of death were further observed in the results from multiple quantile regression models, restricted cubic spline regression models, and a series of subgroup analyses. Anemia is an independent risk factor for HIV/AIDS-related mortality. Our findings may provide new insights into the relevance of PLWHA administration to public health policy, which demonstrate that this low-cost and routinely measured marker (hemoglobin) can be a marker of poor prognosis even before the start of HAART. |
| first_indexed | 2024-04-10T15:03:52Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-10T15:03:52Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj.art-1de753dee6884d5c8b66156a88cf17662023-02-15T07:19:50ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-02-011010.3389/fmed.2023.10551151055115Anemia is independently associated with mortality in people living with human immunodeficiency virus/acquired immune deficiency syndrome: A propensity score matching-based retrospective cohort study in ChinaMeihua Jin0Yanan Wang1Yanan Wang2Yanan Wang3Jing Li4Zhenqian Wu5Xiaoqi Liu6Hui Wang7Hui Wang8Yuxin Chen9Yuxin Chen10Ziyi Wang11Ziyi Wang12Zhaowei Tong13Xiaofeng Li14Feilin Ren15Xiaojuan Zhu16Zhongrong Yang17Guangyun Mao18Guangyun Mao19Guangyun Mao20Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang, ChinaHuzhou Center for Disease Control and Prevention, Huzhou, Zhejiang, ChinaDivision of Epidemiology and Health Statistics, Department of Preventive Medicine, School of Public Health & Management, Wenzhou Medical University, Wenzhou, Zhejiang, ChinaCenter on Evidence-Based Medicine & Clinical Epidemiological Research, School of Public Health & Management, Wenzhou Medical University, Wenzhou, Zhejiang, ChinaHuzhou Center for Disease Control and Prevention, Huzhou, Zhejiang, ChinaHuzhou Center for Disease Control and Prevention, Huzhou, Zhejiang, ChinaHuzhou Center for Disease Control and Prevention, Huzhou, Zhejiang, ChinaDivision of Epidemiology and Health Statistics, Department of Preventive Medicine, School of Public Health & Management, Wenzhou Medical University, Wenzhou, Zhejiang, ChinaCenter on Evidence-Based Medicine & Clinical Epidemiological Research, School of Public Health & Management, Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDivision of Epidemiology and Health Statistics, Department of Preventive Medicine, School of Public Health & Management, Wenzhou Medical University, Wenzhou, Zhejiang, ChinaCenter on Evidence-Based Medicine & Clinical Epidemiological Research, School of Public Health & Management, Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDivision of Epidemiology and Health Statistics, Department of Preventive Medicine, School of Public Health & Management, Wenzhou Medical University, Wenzhou, Zhejiang, ChinaCenter on Evidence-Based Medicine & Clinical Epidemiological Research, School of Public Health & Management, Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Infectious Diseases, Huzhou Central Hospital, Huzhou, Zhejiang, ChinaDepartment of Infectious Diseases, Huzhou Central Hospital, Huzhou, Zhejiang, ChinaHuzhou Center for Disease Control and Prevention, Huzhou, Zhejiang, ChinaHuzhou Center for Disease Control and Prevention, Huzhou, Zhejiang, ChinaHuzhou Center for Disease Control and Prevention, Huzhou, Zhejiang, ChinaDivision of Epidemiology and Health Statistics, Department of Preventive Medicine, School of Public Health & Management, Wenzhou Medical University, Wenzhou, Zhejiang, ChinaCenter on Evidence-Based Medicine & Clinical Epidemiological Research, School of Public Health & Management, Wenzhou Medical University, Wenzhou, Zhejiang, ChinaNational Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, ChinaAlthough previous studies have suggested that hemoglobin is related to the health status of people living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) (PLWHA), the role of anemia in mortality remains unclear. This study aimed to comprehensively quantify the effect of anemia on the mortality risk of PLWHA. In this retrospective cohort study, we thoroughly estimated the effect of anemia on PLWHA mortality, using data collected from January 2005 to June 2022 in the Huzhou area, in 450 subjects extracted from the database of the China Disease Prevention and Control Information System and matched them using a propensity score matching approach to balance potential confounding bias. The potential exposure–response relationship between anemia, hemoglobin concentration, and the mortality of PLWHA was also carefully estimated. A series of subgroup analyses, including interaction analysis, was further conducted to validate the robustness of the effect of anemia on PLWHA death risk. Anemia was significantly associated with an elevated death risk in PLWHA, with an increase of 74% (adjusted hazard ratio [AHR]: 1.74; 95% confidence interval [CI]: 1.03–2.93; p = 0.038) in those with anemia after adjusting for potential confounders. PLWHA with moderate or severe anemia had a higher risk of death, with an 86% increase (AHR = 1.86; 95% CI: 1.01–3.42; p = 0.045). Meanwhile, the AHR tended to increase by 85% on average (AHR = 1.85, 95% CI: 1.37–2.50; p < 0.001) with a per standard deviation (SD) decrease in plasma hemoglobin. Consistent relationships between plasma hemoglobin and the risk of death were further observed in the results from multiple quantile regression models, restricted cubic spline regression models, and a series of subgroup analyses. Anemia is an independent risk factor for HIV/AIDS-related mortality. Our findings may provide new insights into the relevance of PLWHA administration to public health policy, which demonstrate that this low-cost and routinely measured marker (hemoglobin) can be a marker of poor prognosis even before the start of HAART.https://www.frontiersin.org/articles/10.3389/fmed.2023.1055115/fullpeople living with HIV/AIDSHIV/AIDSmortalityanemiapropensity score matching |
| spellingShingle | Meihua Jin Yanan Wang Yanan Wang Yanan Wang Jing Li Zhenqian Wu Xiaoqi Liu Hui Wang Hui Wang Yuxin Chen Yuxin Chen Ziyi Wang Ziyi Wang Zhaowei Tong Xiaofeng Li Feilin Ren Xiaojuan Zhu Zhongrong Yang Guangyun Mao Guangyun Mao Guangyun Mao Anemia is independently associated with mortality in people living with human immunodeficiency virus/acquired immune deficiency syndrome: A propensity score matching-based retrospective cohort study in China Frontiers in Medicine people living with HIV/AIDS HIV/AIDS mortality anemia propensity score matching |
| title | Anemia is independently associated with mortality in people living with human immunodeficiency virus/acquired immune deficiency syndrome: A propensity score matching-based retrospective cohort study in China |
| title_full | Anemia is independently associated with mortality in people living with human immunodeficiency virus/acquired immune deficiency syndrome: A propensity score matching-based retrospective cohort study in China |
| title_fullStr | Anemia is independently associated with mortality in people living with human immunodeficiency virus/acquired immune deficiency syndrome: A propensity score matching-based retrospective cohort study in China |
| title_full_unstemmed | Anemia is independently associated with mortality in people living with human immunodeficiency virus/acquired immune deficiency syndrome: A propensity score matching-based retrospective cohort study in China |
| title_short | Anemia is independently associated with mortality in people living with human immunodeficiency virus/acquired immune deficiency syndrome: A propensity score matching-based retrospective cohort study in China |
| title_sort | anemia is independently associated with mortality in people living with human immunodeficiency virus acquired immune deficiency syndrome a propensity score matching based retrospective cohort study in china |
| topic | people living with HIV/AIDS HIV/AIDS mortality anemia propensity score matching |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1055115/full |
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