Information Handout on
Anemia & HIV/AIDS
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 Management
To 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.