Clinically significant anemia in HIV-infected pregnant women in India is not a major barrier to zidovudine use for prevention of maternal-to-child transmission

Gita Sinha, Tou J. Choi, Uma Nayak, Amita Gupta, Sandeep Nair, Nikhil Gupte, Pandurang M. Bulakh, Jayagowri Sastry, Sanjay D. Deshmukh, Medha M. Khandekar, Vandana Kulkarni, Ramesh A. Bhosale, Kapila E. Bharucha, Mrudula A. Phadke, Anandini S. Kshirsagar, Robert C. Bollinger

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: To determine the prevalence of anemia (serum hemoglobin <10 g/dL) and assess zidovudine use and toxicity in HIV-positive pregnant women in India. METHODS: From 2002 through 2006, 24,105 pregnant women in Pune were screened for HIV and anemia. As part of an infant prevention of mother-to-child transmission (PMTCT) trial, enrolled HIV-positive women (n = 467) were assessed for anemia and associated outcomes, comparing women receiving zidovudine for ≥2 weeks versus no zidovudine. RESULTS: The prevalence of anemia was 38.7% in HIV-positive women. Anemic women were as likely as nonanemic women to receive zidovudine. At delivery, regardless of anemia status at enrollment, women receiving ≥2 weeks of zidovudine were 70% less likely to be anemic compared with women receiving no zidovudine (odds ratio = 0.28, 95% confidence interval: 0.14 to 0.57; P < 0.01), received iron and folic acid supplements for longer periods, and had no increased adverse delivery or newborn birth outcomes. CONCLUSIONS: A significant proportion of HIV-positive pregnant women in India present for antenatal care with anemia. With concurrent iron and folic acid supplementation, however, zidovudine use is not associated with persistent or worsening anemia or associated adverse outcomes. In Indian community settings, all pregnant HIV-positive women should receive early anemia treatment. Mild anemia should not limit zidovudine use for PMTCT in India.

Original languageEnglish (US)
Pages (from-to)210-217
Number of pages8
JournalJournal of acquired immune deficiency syndromes
Volume45
Issue number2
DOIs
StatePublished - Jun 1 2007

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Keywords

  • Anemia
  • HIV
  • India
  • Pregnancy
  • Prevention of maternal-to-child transmission
  • Zidovudine

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Sinha, G., Choi, T. J., Nayak, U., Gupta, A., Nair, S., Gupte, N., Bulakh, P. M., Sastry, J., Deshmukh, S. D., Khandekar, M. M., Kulkarni, V., Bhosale, R. A., Bharucha, K. E., Phadke, M. A., Kshirsagar, A. S., & Bollinger, R. C. (2007). Clinically significant anemia in HIV-infected pregnant women in India is not a major barrier to zidovudine use for prevention of maternal-to-child transmission. Journal of acquired immune deficiency syndromes, 45(2), 210-217. https://doi.org/10.1097/QAI.0b013e3180556000