Women, Anemia and HIV/AIDS

Table of Contents

• What Is Anemia?
• What Causes Anemia?
• Anemia and HIV
• Women and Anemia
• Diagnosis and Treatment
• Taking Care of Yourself

What Is Anemia?

Anemia is a medical condition that occurs when you have a lower than normal amount of red blood cells (RBCs) in your body. It can also happen if your hemoglobin (HGB) level is below normal. HGB is a protein that uses iron to carry oxygen. It is found in RBCs and gives blood its red color. HGB carries oxygen from the lungs to the rest of the body. Oxygen is necessary for the body to make energy and carry out all its functions. If you have anemia, your body does not carry enough oxygen in your blood.

Anemia can be mild, moderate, or severe. It can also be temporary or a longer-lasting problem. With severe or long-lasting anemia, the lack of oxygen in the blood can damage the heart, brain, and other organs of the body. Very severe anemia can even cause death. The good news is, anemia can be identified and treated.

At first, anemia can be so mild that it goes unnoticed. Symptoms usually appear and get worse as the anemia gets worse. Symptoms can include:

• Severe fatigue (tiredness)
• Difficulty breathing; being short of breath
• Rapid heart rate
• Pale skin
• Decreased pinkness of the lips, gums, lining of the eyelids, nail beds, and palms
• Feeling cold
• Confusion or loss of concentration
• Dizziness or fainting
• Sadness or depression

What Causes Anemia?

There are many possible causes of anemia, including:

• A shortage of iron, which is most commonly due to blood loss from heavy or long menstrual periods, frequent nosebleeds, or internal bleeding; referred to as 'iron deficiency anemia'
• A shortage of B vitamins: a shortage of the vitamin B12 is referred to as 'pernicious anemia;' a shortage of the B vitamin folic acid (folate) can also cause anemia
• HIV infection itself
• Many opportunistic infections (OIs) related to HIV disease
• Kidney or bone marrow damage
• Some thyroid conditions
• Some drugs that are commonly used to treat HIV and related infections

Anemia and HIV

Anemia has been a long-standing problem for people living with HIV (HIV+). Although serious anemia has become less common since people started using a combination of HIV drugs, anemia continues to affect up to 3 out of 10 of HIV+ people, and 8 out of 10 of people living with AIDS. Factors that are linked to a greater likelihood of anemia in HIV+ people include:

• Being a woman
• Being African-American
• Having lower CD4 cell counts
• Having a higher viral load
• Poor nutrition: not eating enough of the right foods, or not taking in the nutrients of the foods eaten (malabsorption) (For more information, see our Nutrition and HIV info sheet)
• Taking Retrovir (zidovudine, AZT)
• Certain hepatitis C drugs (ribavirin)

Anemia is a common condition for HIV+ women, and it is often overlooked. If left untreated, anemia is strongly associated with HIV disease progression and an increased risk of death.