The Predictive value of anaemia in determining mortality in patients with HIV at the University Teaching Hospital, Lusaka, Zambia

Abstract

Objective: The aim of the study was to determine the predictive values of anaemia (lower levels of haemoglobin), CD4 count and WHO clinical staging in determining mortality among HIV positive patients enrolling on the ART programme.Design/ Setting: It was a diagnostic study conducted over six months at the UTH Department of Medicine. A total of 340 patients that enrolled on the GRZ ARVs scheme at UTH were recruited. Of these 170 were deceased and 170 were living. Diagnostic parameters of the initial CD4 count, haemoglobin and WHO clinical staging were done on all the patients who participated in the study. The information collected was entered onto the questionnaires for analysis.Results: The majority of patients were between the age group of 31 - 40 years (42.9%), with more females (56.8%) than males. A large number of patients 82.9% were anemic. In predicting mortality, CD4 count had the highest sensitivity of 94.1%. WHO clinical staging had a sensitivity of 77.7 %>, and haemoglobin had a sensitivity of 68.2%. Combined haemoglobin, CD4 count and WHO clinical staging had relatively lower sensitivities between the ranges of 52.4% and 65.9%.Conclusion: Most of the patients enrolling for ART were anaemic. WHO clinical staging, CD4 count and haemoglobin levels are good predictors of mortality and therefore can be used to identify patients at high risk. Recommendations: All patients with HIV enrolling for the ART program should be screened for anaemia.Haemoglobin levels and WHO clinical staging can be used to identify patients at highest risk of mortality in resource limited areas where CD4 counts and viral loads are not available.