Haemoglobin and anaemia in the SMART study

Amanda Mocroft, Alan R. Lifson, Giota Touloumi, Jacqueline Neuhaus, Zoe Fox, Adrian Palfreeman, Michael J. Vjecha, Sally Hodder, Stephane De Wit, Jens D. Lundgren, Andrew N. Phillips

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Background: Data from randomized trials on the development of anaemia after interruption of therapy are not well-described. Methods: A total of 2,248 patients from the SMART study were included. We used Cox proportional hazards models to investigate development of new (≤12 mg/dl for females and ≤14 mg/dl for males) or worsening (≤8 mg/dl if anaemic at randomization) anaemia and Poisson regression analyses to explore the relationship between anaemia and the development of AIDS, death or non-AIDS events. Results: Overall, 759 patients developed new or worsening anaemia: 420/1,106 (38.0%) in the drug conservation (DC) arm and 339/1127 (30.1%) in the viral suppression (VS) arm (P<0.0001). At 4 months after randomization, patients in the DC arm had a significantly increased risk of developing new or worsening anaemia (adjusted relative hazard 1.56, 95% CI 1.28-1.89). Currently anaemic patients had an increased incidence of AIDS (adjusted incidence rate ratio [IRR] 2.31, 95% CI 1.34-3.98), death (adjusted IRR 2.19, 95% CI 1.23-3.87) and non-AIDS events (adjusted IRR 2.98, 95% CI 2.01-4.40) compared to non-anaemic patients. Conclusions: Patients who interrupted combination antiretroviral therapy had a higher risk of new or worsening anaemia. Anaemic patients had a higher incidence of AIDS, non-AIDS defining events or deaths, possibly due to deteriorating health and subclinical disease.

Original languageEnglish (US)
Pages (from-to)329-337
Number of pages9
JournalAntiviral Therapy
Issue number3
StatePublished - 2011


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