Experience with epoetin alfa & acquired immunodeficiency syndrome anemia

Anemia is common in patients infected with the human
immunodeficiency virus (HIV). The etiology is often
multifactorial and may include the HIV infection itself,
opportunistic infections, cancer, medications (particularly
zidovudine and sulfa-containing drugs), or anemia of chronic
disease. Epoetin alfa therapy may play a supportive role in
some HIV-infected patients by increasing hemoglobin,
decreasing fatigue, and reducing the need for exposure to red
blood cell transfusions. A large, placebo-controlled trial in
the United States for anemic patients with the acquired
immunodeficiency syndrome taking zidovudine demonstrated a
statistically significant improvement in hematocrit in
patients treated with epoetin alfa compared with placebo.
Transfusion requirements decreased in epoetin alfa-treated
patients over a 3-month period compared with placebo with a
trend toward improvement in quality of life. Epoetin alfa was
effective, however, only in patients whose pretreatment
erythropoietin levels were less than 500 mU/mL. These
advantages of epoetin alfa treatment may become especially
important as HIV becomes more of a chronic disease, with the
concern that red blood cell transfusion may accelerate
progression of HIV.

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