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 ManagementTo 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.

Information Handout onAnemia & HIV/AIDS