Anemia is a common complication of HIV. There are numerous possible causes, including HIV itself, related infections, and some HIV medications. Taking certain medications and adjusting nutrition may help.

Anemia happens when there are not enough healthy red blood cells (RBCs) to transport oxygen throughout the body.

If you have anemia and HIV, a medical professional will work with you to determine the exact cause of anemia. While HIV can directly cause anemia, it may also happen due to some medications for HIV or as a result of an opportunistic infection.

Read on for more information about anemia and HIV, including the causes and symptoms, treatment options, and more.

There are multiple possible causes of anemia in people with HIV, including:

Opportunistic infections are infections that occur in people with a weakened immune system. Some studies suggest that severe anemia was more common in people with HIV and either Kaposi sarcoma or tuberculosis (TB).

Anemia can also happen due to a deficiency of one of the following:

Nutritional deficiencies can be common in people with HIV.

In mild cases, anemia may not cause any symptoms.

When symptoms do develop, anemia may cause:

If these symptoms develop or if you have concerns about developing anemia, it is important to contact a medical professional for advice.

According to a 2022 review, the worldwide prevalence of anemia among people with HIV was as follows:

  • 46.6% of adults who were not pregnant
  • 48.6% of pregnant people
  • 39.7% of children under the age of 15 years

The International Association of Providers of AIDS Care suggests that anemia in people with HIV has become less common with the use of combination ART, and severe anemia is rare.

However, they also note that 46% of people with HIV had mild or moderate anemia even after receiving ART for 1 year.

Factors that increase the likelihood of developing anemia in people with HIV include:

  • having an iron, vitamin B12, or folate deficiency
  • certain ART medications
  • having a secondary infection
  • having a low CD4 count

You can speak with a medical professional if you have concerns about the risk factors for anemia. They can provide advice on ways to help reduce the risk.

Blood tests can help diagnose anemia. The medical professional will also likely take a full medical history and perform a physical exam.

Medical professionals may also order a bone marrow aspiration and biopsy to assess the red blood cells.

If a medical professional suspects that anemia is due to a secondary infection or deficiency, they may order additional tests.

Treatment for HIV-related anemia can depend on the underlying cause, but may include:

  • following a treatment plan for HIV, which may include ART medications
  • treating any chronic bleeding, such as nosebleeds, gastrointestinal bleeding, or hemorrhoids
  • taking relevant dietary supplements at the advice of a medical professional
  • receiving erythropoietin (EPO) injections to stimulate the production of RBCs
  • blood transfusions in severe or life threatening cases

It may not be possible to completely prevent anemia if a person has HIV. However, steps that may help minimize the likelihood of developing anemia include:

  • asking a medical professional about antimicrobial therapy or other treatments to reduce the risk of other opportunistic infections
  • taking ART medication
  • getting regular screenings for blood disorders

A medical professional can provide more information on steps you can take to reduce the risk of anemia.

There are numerous causes of anemia in people with HIV. Examples include problems with the bone marrow, nutritional deficiencies, opportunistic infections, and some HIV medications.

Managing any bleeding, following a medical professional’s recommendations for supplements, and taking ART medication may help.

A medical professional can provide more advice on ways to treat and reduce the risk of anemia in people with HIV.