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Fatigue and AnemiaFatigue and Anemia
          
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Injections or transfusion??
Jun 1, 2000

Doctor Frascino, I trust your opinions. thanks for everything you do for the HIV community. I have a question for you. My practitioner said I should wait to treat my anemia until I need a transfusion because it's better and safer than taking shots everyday. Which is safer the shots or a blood transfusion? Q.

Response from Dr. Frascino

Hi Q,

The best treatment for anemia is to identify all the contributing causes and treat those causes, which have specific therapies. There are multiple treatable causes of anemia in the setting of HIV disease. For example: opportunistic infections (MAC, tuberculosis, parvovirus B-19), opportunistic malignancies: (lymphomas), nutritional deficiencies: (vitaminB-12, folic acid, or iron), even HIV itself can cause anemia. In addition, some drugs used to treat HIV or its complications can suppress bone marrow function and therefore induce anemia. These medications include AZT, combivir, gancyclovir, pentamidine, and various cancer chemotherapies.

Transfusions can be very useful but should be reserved for severe, symptomatic anemia or special situations such as acute blood loss, surgical procedures etc. Erythropoietin (PROCRIT) is the preferred treatment for all but the most severe cases. Blood transfusions can be problematic for HIV positive people. Clinical studies have shown increases in viral load following blood transfusion. Transfused blood causes additional suppression of the immune system. Additional risks of transfusion include iron overload and transmission of bloodborne infections. Transfusions also provide only temporary relief and do not treat the underlying cause of the anemia problem.

Your question mentioned taking shots "everyday". PROCRIT is effective when administered just once per week. PROCRIT stimulates the production of new red blood cells, which is preferable to transfused cells. PROCRIT has very few side effects and is easy to administer compared to blood transfusions.

Clinical studies in patients with HIV have shown PROCRIT to be highly effective in treating even mild to moderate anemia significantly improving energy level and quality of life. In summary, PROCRIT's safety, lack of side effects, and ease of administration -- especially compared to blood transfusions -- makes it the preferred treatment.

RJF


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