If your body does not make enough red blood cells, this can cause you to feel tired and sluggish because there is not enough oxygen moving from your lungs to the rest of your body. This condition is known as anemia and is sometimes referred to as "tired blood." Among people with HIV, anemia is the most commonly seen disorder related to the production of blood.

What Causes Anemia?

Anemia can result from low red blood cell production or the destruction or loss of red blood cells in your body. This can be caused by:

• Too little iron, vitamin B₁₂, or folate in your body
• Damage to the bone marrow or the kidneys
• A woman losing blood due to her period
• HIV infection or other types of infection
• HIV medications

HIV and Anemia HIV infection has been shown to cause anemia. The introduction of highly active antiretroviral therapy, or HAART, in the mid 1990s reduced the number of cases of anemia seen among people with HIV. If you are HIV+, there are a number of factors that can increase the likelihood that you have or will develop anemia, such as:

• Lower CD4 cell counts
• Higher viral load
• Taking certain HIV medications
• Being African American
• Being a woman

The bad news is that anemia can affect your HIV infection. Evidence suggests that HIV disease progression is more likely in people with anemia. The good news is that treatment of anemia can eliminate these risks. If you are HIV+, and you think you may have anemia, talk to your healthcare professional about a simple blood test to determine if you have anemia.

So, I Have Anemia. What Can I Do?

How you treat anemia depends on what is causing it. If you are HIV+ and have anemia, here are some basic things that you can do:

If you do get symptoms of HBV infection (yellowing of the skin and whites of the eyes, loss of appetite, nausea and vomiting, and a fever), see your healthcare provider immediately.

• Stop any unnecessary bleeding—if you have hemorrhoids or get nosebleeds often, talk to your healthcare provider. There are things he or she can do to help
• Increase the amount of iron, vitamin B12, and folate in your diet—eating more meat, especially red meat, spinach, peanuts, peanut butter, almonds, eggs, peas, beans, dried fruits, and prune juice can increase the amount of iron in your body. Taking vitamin C can also help your body get more iron from the foods you eat. To get more vitamin B12, try eating breakfast cereals high in B12, as well as meat, eggs, and dairy products. Finally, folate can be found in bread, pasta, rice, spinach, eggs, bananas, oranges, and orange juice. However, it is still important to talk to your healthcare provider before making any changes to your diet.

There are 2 other things that you and your healthcare provider might suggest to treat your anemia:

• Drugs that can help your body make more red blood cells—recent evidence has shown that taking this type of drug can decrease the risk of death among people with HIV with anemia.


• Blood transfusions—this is a last resort because there are many risks associated with it. Transfusions can cause infection and further weaken your immune system.