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HIV and Anemia: An Overlooked Danger

Summary & Participants

It's been estimated that up to 95% of people infected with HIV will experience anemia at some point. Unfortunately, it is often overlooked, and untreated anemia can lead to dangerous complications. Join Dr. Lisa Capaldini and Dr. Brian Boyle as they discuss symptoms, diagnosis, and treatment options, and share important advice for those living with HIV.

Medically Reviewed On: June 28, 2008

Webcast Transcript

RENEE KEMP: Welcome to our webcast. I'm Renee Kemp. Anemia is a condition in which your body's red blood cells can't carry enough oxygen for your body to be healthy. Many people can develop anemia, but people living with HIV may have some added risks and may need to be especially concerned. Joining me today to discuss anemia and people living with HIV is Dr. Lisa Capaldini. She's in private practice in San Francisco. Thank you for joining me, Dr. Capaldini.

We've seen signs suggesting that people living with HIV should ask about their third number, referring to their hematocrit. What does that mean?

LISA CAPALDINI, MD: Well, it's talking about paying attention to red blood cell count in addition to the first two numbers that people are more familiar with, meaning their T cells and their viral load. The red blood cell count determines how tired you are, how well your body carries oxygen, and we're learning that a lot of people with HIV who are doing well in terms of their viral load or their T cells may feel tired because they're anemic, and they don't know they're anemic because they haven't really focused on this third number when looking over their labs with their clinicians.

RENEE KEMP: If you would, Dr. Capaldini, explain what is anemia, and just how common is it among people living with HIV?

LISA CAPALDINI, MD: Anemia means you don't have enough red blood cells, and anemia is very common in advanced HIV disease and less common in earlier stages. So if you look at HIV people across the board, probably about 30% of people are anemic, with people with advanced AIDS being over 50% anemia and people with early HIV being under 10%.

RENEE KEMP: Is anemia something that is routinely diagnosed?

LISA CAPALDINI, MD: Anemia is routinely diagnosable, although it's often not noted by clinicians or patients. What I mean by that is when you get a T cell count, you normally get a blood test called a complete blood count, of which blood cell analysis is part of that. Usually, the data is there. It's a matter of the clinician and the patient noting that anemia is present and deciding to do something about it.

RENEE KEMP: What is it that causes anemia among people who live with HIV?

LISA CAPALDINI, MD: Well, worldwide, outside of HIV, the biggest causes of anemia are nutritional problems -- iron deficiency and vitamin deficiency. In people with HIV disease, vitamin deficiencies are possible, but relatively uncommon as causes of anemia. More often, anemia can be caused by medications, certain antivirals, certain drugs that are used to treat infections, chemotherapeutic agents. Some opportunistic infections, like mycobacterium avium, can cause anemia. Occasionally, people have what are called autoimmune conditions where their body destroys their own red blood cells.

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