Incidence of anemia induced by zidovidune in goma town, democratic rebupblic of the congo

Introduction: 
The zidovudine (ZDV) is one of the preferred nucleoside reverse transcriptase inhibitor in the first line antiretroviral treatment in DR Congo. It is known to be associated with life threatening toxicity such as anemia. For this reason, in the Democratic Republic of Congo (DRC), the national program has a tendency to gradually replace this molecule by tenofovir. Yet, its therapeutic efficacy is fully demonstrated but not many studies have been carried out in the country in order to assess the factors associated with this toxicity. This study was aimed at determining the prevalence of anemia induced by ZDV to HIV infected patients under therapeutic regime containing this antiretroviral also to find out the factors which favour the induction of that anemia.
Methods:
This study was conducted in the two major health facilities in support of HIV infection in the city of Goma. Patients were treated according to the National program guidelines of the DRC to Fight against HIV (PNLS).
Patients (N = 685) with hemoglobin (Hb) > 8 g/dL were submitted to a diet containing ZDV.
Anemic patients developing anemia (< 8 g/dL) with other causes of anemia were excluded from the cohort. Correlation of baseline characteristics of the sample study population (age, gender, hemoglobin levels, weight, CD4 counts and WHO clinical stage) with risk of developing anemia was also calculated.
Results: 
One hundred and one patients or 16.1% on ZDV regimen developed anemia with a rate of hemoglobin (< 8 g/dL). Men were more thin-skinned to develop anemia with a sex ratio of 3.4 for males 17.3% and females 16.9%. The low average weight (46 ± 8.02), the mean CD4 count below 200 /μL (117 ± 77.4) at the beginning of treatment, the diet with ZDV in first intention (73.3%) were incriminated in the occurring of anemia induced by ZDV. Age, clinical stage of the disease according to WHO and the hemoglobin at treatment had no connection with the development of anemia.
Conclusion: 
The high incidence of anemia caused by ZDV in this study indicates that patients with a low average weight, a CD4 count below 200 /μL early treatment should benefit from closer monitoring. A regimen with ZDV in second line will minimize the risk of anemia induced by ZDV.