Dear Dr. I was diagnosed HIV pos 14 months ago, and have been on Atripla for a year now. My Viral load levels are now indetectable, and CD4 went from 280 to 460 after atripla, however my hemoglobin and hematocrit have not changed; my Hb is still 12.4 Gr/l and Hematocrit 37%. my Iron, transferrin and ferritin levels are normal. Is there a long term consecuence to this anaemia?. My Dr does not seeem concerned, but I wonder if I should be considering Procrit or another EPO drug to increase my red blood cells count? I would appreciate you views on this. Thank you in advance Paco

Hello Paco,

Your hemoglobin level of 12.4 is only mildly low (normal range for men is 14-18 g/dL). I would not recommend Procrit/EPO for this mild degree of anemia. You report your hemoglobin level has remained stable for the past 14 months and your iron studies are normal. It is possible you have "anemia of chronic disease" resulting from longstanding HIV disease. If your initial CD4 count was 280, chances are you've been infected for a number of years (perhaps 7 to 10 years). You can read about anemia of chronic disease as well as the other causes of HIV-related anemia in the archives of this forum. You should then discuss this information with your HIV specialist. I agree with your doctor: Your degree of anemia is not at this point concerning. However it should be routinely monitored and effort should be made to search for underlying causes of anemia (blood loss, occult infections, drug side effects, etc.).

Good luck.

Dr. Bob