Journal Article

A Comprehensive Plan for Managed Care of Patients Infected with Human Immunodeficiency Virus

John G. Bartlett and Richard Moore

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 29, issue 1, pages 50-55
Published in print July 1999 | ISSN: 1058-4838
Published online July 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/520179
A Comprehensive Plan for Managed Care of Patients Infected with Human Immunodeficiency Virus

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Anemia, a common hematologic complication in human immunodeficiency virus (HIV)—infected patients, can be caused by mechanisms including infections, neoplasms, or drug treatment. Studies have consistently found anemia to be associated with reduced survival, even when potentially confounding factors were controlled for. Importantly, recovery from anemia has been shown to reduce this risk to approximately the same level as seen among patients never having had anemia. Although anemia traditionally has been treated with blood transfusions, recent studies have shown recombinant human erythropoietin (r-HuEPO) to be effective in elevating hematocrit values and reducing transfusion requirements in HIV-infected patients who have endogenous erythropoietin levels of ⩽500 IU/L. Therapy with r-HuEPO has been shown to be safe and well tolerated. In a recent study, moreover, receipt of erythropoietin was associated with a decreased risk of death, whereas transfusion was associated with an increased risk. If these results are confirmed, the link between r-HuEPO and decreased risk of death in HIV-infected patients with anemia will be further strengthened.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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