PMID- 23028732
OWN - NLM
STAT- MEDLINE
DCOM- 20130226
LR  - 20220321
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 7
IP  - 9
DP  - 2012
TI  - Hemoglobin may contribute to sex differences in mortality among HIV-infected 
      persons in care.
PG  - e44999
LID - 10.1371/journal.pone.0044999 [doi]
LID - e44999
AB  - BACKGROUND: Some retrospective studies have found that HIV-infected women have a 
      higher mortality risk than men after adjusting for baseline characteristics, 
      while others have not. Anemia is a known predictor of HIV-related mortality. We 
      assessed whether anemia contributed to the sex difference in mortality in our 
      cohort. METHODS: We conducted a retrospective cohort study among HIV-infected 
      persons in care at the Comprehensive Care Center (Nashville, TN) between 1998 and 
      2009. Cox proportional hazards models compared time from first clinic visit to 
      death and AIDS-defining events (ADE), adjusted for baseline characteristics with 
      and without baseline hemoglobin. RESULTS: Of 3,633 persons, 879 (24%) were women. 
      Women had lower median baseline hemoglobin compared to men: 12.4 g/dL 
      (inter-quartile range (IQR) 11.3-13.4) vs. 14.4 (IQR 13.1-15.5), respectively 
      (P<0.001). In multivariable models without hemoglobin, the risk of death was 
      higher among women: hazard ratio (HR) 1.46 (95% confidence interval (CI) 1.17, 
      1.82; P=0.001). In multivariable models with hemoglobin, the risk of death in 
      women was diminished and no longer statistically significant: HR 1.2 (95% CI 
      0.93, 1.55; P=0.17). The risk of ADE was higher among women in both models, but 
      not statistically significant: HR 1.1 (95% CI 0.85-1.42; P=0.46) in the model 
      without hemoglobin and 1.11 (95% CI 0.82-1.48; P=0.50) in the model with 
      hemoglobin. Hemoglobin was a strong predictor of death: HR 0.88 per 1 g/dL 
      increase (95% CI 0.83, 0.93; P<0.001). CONCLUSION: In our study population of 
      HIV-infected persons in care, women had lower baseline hemoglobin, and lower 
      hemoglobin contributed to their higher risk of ADE and death.
FAU - Melekhin, Vlada V
AU  - Melekhin VV
AD  - Division of Infectious Diseases, Department of Medicine, Vanderbilt University 
      School of Medicine, Nashville, Tennessee, USA. vlada.melekhin@vanderbilt.edu
FAU - Shepherd, Bryan E
AU  - Shepherd BE
FAU - Stinnette, Samuel E
AU  - Stinnette SE
FAU - Rebeiro, Peter F
AU  - Rebeiro PF
FAU - Turner, Megan M
AU  - Turner MM
FAU - Sterling, Timothy R
AU  - Sterling TR
LA  - eng
GR  - K23AI080227/AI/NIAID NIH HHS/United States
GR  - P30 AI054999/AI/NIAID NIH HHS/United States
GR  - K24 A1065298/PHS HHS/United States
GR  - P30 AI54999/AI/NIAID NIH HHS/United States
GR  - K24 AI065298/AI/NIAID NIH HHS/United States
GR  - K23 AI080227/AI/NIAID NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20120913
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Hemoglobins)
SB  - IM
MH  - Adult
MH  - Comprehensive Health Care
MH  - Demography
MH  - Disease Progression
MH  - Female
MH  - HIV Infections/blood/*metabolism/*mortality
MH  - Hemoglobins/*metabolism
MH  - Humans
MH  - Male
MH  - Models, Biological
MH  - Proportional Hazards Models
MH  - *Sex Characteristics
PMC - PMC3441736
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2012/10/03 06:00
MHDA- 2013/02/27 06:00
PMCR- 2012/09/13
CRDT- 2012/10/03 06:00
PHST- 2012/02/03 00:00 [received]
PHST- 2012/08/14 00:00 [accepted]
PHST- 2012/10/03 06:00 [entrez]
PHST- 2012/10/03 06:00 [pubmed]
PHST- 2013/02/27 06:00 [medline]
PHST- 2012/09/13 00:00 [pmc-release]
AID - PONE-D-12-03680 [pii]
AID - 10.1371/journal.pone.0044999 [doi]
PST - ppublish
SO  - PLoS One. 2012;7(9):e44999. doi: 10.1371/journal.pone.0044999. Epub 2012 Sep 13.