Some HIV-related meds are behind a wearying blood condition
You’re probably familiar with those immune-system soldiers, white blood cells. You also need red blood cells—they deliver oxygen throughout your body. Anemia means that you don’t have enough red blood cells or they’re not carrying enough oxygen. The result? Fatigue, pale skin, short breath, heart palpitations, headaches and dizziness.
It’s crucial to diagnose the problem as early as possible: Studies show that anemic HIV positive people have shorter life spans than their perkier peers. If your fatigue gets worse when you exercise, that’s a telltale sign—but your doc can easily test you for it.
Anemia has many causes, ranging from heavy menstrual bleeding to a lack of iron, folic acid or vitamin B-12. Unfortunately, it can also be triggered by some drugs used to treat HIV or HIV-related illnesses. AZT (Retrovir) or one of the combo pills that contain it (Combivir or Trizivir) can cause anemia by damaging your bone marrow, where red blood cells are made. Other meds to watch out for are TMP-SMX and dapsone (both used to prevent PCP), ganciclovir (to prevent CMV), ribavirin (used with interferon to treat hepatitis C) and chemotherapy for cancer.
For AZT-related anemia, one solution may be to switch to another HIV med in the “nuke” class; with so many available, a change doesn’t have to mean new side effects. Switching may also work for anemia caused by drugs other than AZT. If it won’t, there is also erythropoietin, or Procrit, an injectable hormone that prompts your bone marrow to make more red blood cells. Procrit relieves fatigue and other anemia symptoms.
Jack Miller ditched AZT for aerobics
Jack Miller, 32, is an HIV veteran. He was diagnosed so long ago—1994 to be exact—that he was put on AZT monotherapy. He developed anemia and with it came fatigue. “Resting didn’t help—it just got worse,” he says. So much so that in 1996, Miller, who was then a nurse’s aide, went on disability. Then combo therapy came along. By 2000, he was on a regimen without AZT. “That helped my fatigue a lot,” he says. These days, Miller has the energy to volunteer at a Brooklyn AIDS service organization and even does aerobics. “The fatigue is manageable now,” he says, but life isn’t always perfect: “I did some grocery shopping the other day and had to sit for a minute.”
Screen It and Treat It
Screen It… There are three main tests to tell whether you have anemia. • A complete blood count inventories your red and white cells and platelets. • A hematocrit test tells you what portion of your blood is made up of red blood cells. • A hemoglobin test looks for the protein hemoglobin, which helps red cells deliver oxygen to the body.
...and Treat It • For med-related anemia, switching to another drug or lowering a dose can often do the trick. If AZT is part of your combo, you can try another HIV med in the same class, such as tenofovir (Viread) or abacavir (Ziagen)—your doc can help guide you. • If meds aren’t the issue, injectable Procrit is a red-blood-cell booster. It can take several weeks to work.