Anaemia in HIV-infected children: severity, types and effect on response to HAART

Ruhinda, Eunice Nyesigire; Bajunirwe, Francis; Kiwanuka, Julius

doi:10.1186/1471-2431-12-170

Cited by 36 publications

(38 citation statements)

References 13 publications

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“…Thrombocytopenia was observed in 8.1% of the study patients, which is consistent with the study done in India, 7%, 24 in Uganda 8.3%, 23 and in Jima, Ethiopia, 7.8%. 26 Observation in other studies also identified thrombocytopenia in 10%–30% of HIV-infected patients and increased incidence was found to be associated with the progression of HIV disease.…”

Section: Discussionsupporting

confidence: 91%

“…The prevalence of anemia before the initiation of ART in this study was 95 (42.8%). This is similar to the studies done in Brazil, 37.5%, 22 and Uganda 47.8% 23 but lower than the Indian study 65.5%. 24 These differences may be due to differences in study populations, socio-demographic characteristics of the study patients, sample size difference and diagnostic criteria used for anemia.…”

Section: Discussionsupporting

confidence: 89%

“…In the current study, young age (<5 years), advanced stage and immunosuppression were independently associated with anemia which is consistent with other published studies. 29 Published literature on this area indicates that disease progression and severe immunosuppression are associated with cytokine-mediated myelosuppression resulting in multiple hematologic abnormalities, including anemia. 30 …”

Section: Discussionmentioning

confidence: 99%

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Hematologic abnormalities and associated factors among HIV infected children pre- and post-antiretroviral treatment, North West Ethiopia

Geletaw¹,

Tadesse²,

Demisse³

2017

JBM

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IntroductionThere are few studies on the hematologic parameters of HIV-infected individuals in Ethiopia; of these, almost all studies researched adults. Our current study is unique in that it mainly focused on the pediatric population and compared both pre- and post-antiretroviral therapy (ART) children. Inference from this study can be used for other developing countries where the burden of HIV disease is high.ObjectiveThe aim of this study was to identify hematologic abnormalities in HIV-infected children before and after initiation of ART.MethodologyA cross-sectional study was conducted on HIV-infected children from June 1 to August 30, 2015. Data were collected using a pretested and structured questionnaire. Statistical analysis was performed using SPSS 20 version.ResultsThe median age of study subjects was 10 years with an interquartile range (IQR) of (6, 12). Two-thirds (74.3%) of study subjects received ART for >1 year. The median of CD4 count before ART was 490 cells/mm3 with an IQR of (286, 765); this increased to 663 cells mm3 with an IQR of (499, 908) after ART. Likewise, the median of hemoglobin before ART was 11.5 mg/dL with an IQR of (9.9, 13), which increased after ART to 13 mg/dL with an IQR of (11.8, 14). The prevalence of anemia was 42.8% before and 18.9% after ART initiation. The median of absolute neutrophil count before ART was 3×103 with an IQR of (2.1, 4.6) and after ART, it became 3×103 with IQR of (1.9, 4.2). Age <5 years (adjusted odds ratio [AOR]: 2.76; 95% CI: 1.5, 5.0), an advanced stage of AIDS (AOR: 2.8; 95% CI: 1.4, 5.6) and CD4% <25% (AOR: 2.4; 95% CI: 1.2, 4.9) were significantly associated with anemia before ART initiation, while opportunistic infections were associated with anemia after initiation of ART (AOR: 2.3; 95% CI: 1.08, 4.8).ConclusionART positively or negatively affects the hematologic profile of HIV-infected children. The current study demonstrated a significant reduction of anemia after initiation of ART.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Hematologic abnormalities and associated factors among HIV infected children pre- and post-antiretroviral treatment, North West Ethiopia

Geletaw¹,

Tadesse²,

Demisse³

2017

JBM

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“…Evidence from other studies also shows anemia at ART initiation associated with increased mortality, disease progression (poor virologic response) and reduced quality of life. [27][28][29] Figure 1 Cumulative probability of first-line ART failure among patients in JUSH between 1st January 2010 and 30th June 2016, Ethiopia.…”

Section: Discussionmentioning

confidence: 99%

<p>Predictors of Clinical and Immunological Failure Among Patients on First-Line Antiretroviral Therapy (ART) in Southwest Ethiopia</p>

Asefa

Asaye

Girma

et al. 2019

HIV

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Background: Global expanded access to antiretroviral therapy has led to a rapid fall in the number of people dying from HIV-related causes. However, the remarkable achievement recorded in reducing morbidity and mortality has been affected due to the occurrence of firstline ART failure. The study was intended to identify predictors of clinical and immunologic failure of first-line ART in southwest Ethiopia. Methods: A retrospective cohort study was conducted among 737 randomly selected ART patients from 1 st January 2010 to 30 th June 2016. Trained data collectors collected the data from the patients' follow-up charts and electronic databases. The Kaplan Meier (KM) curve was used to describe the probability of survival time to antiretroviral treatment failure. Variables with a p-value of ≤ 0.05 in a multivariable cox-proportional hazard model were statistically significant predictors of first-line ART failure. Results: Among 737 HIV patients on ART followed retrospectively, 445 (60.4%) were females. During the follow-up period, the incidence rate of treatment failure was 7.3 per 100 person-year observations, and the highest rate was observed during the first 6 to 12 months of ART initiation. Not disclosing HIV status (AHR꞊ 2.04, 95% CI: 1.32-3.16), being bedridden (AHR꞊ 2.01, 95% CI: 1.02-3.98) and low hemoglobin at ART initiation (AHR꞊ 2.02, 95% CI: 1.29-3.13) were associated with an increased hazard rate for first-line ART failure. Conclusion: The study showed that predictors of first-line ART treatment failure are modifiable. Therefore, these factors should be addressed during routine care of HIV patients by health care providers to preserve the rapid exhaustion of first-line medications, improve the quality of life of the patients and reduce HIV/AIDS related deaths.

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“…In sub-Saharan Africa, microcytic anemia (defined as anemia with MCV < 80 fl) is mainly due to iron deficiency, whereas normocytic anemia (defined as anemia with MCV of 80–100 fl) is usually due to anemia of chronic disease. 3,12,13 Macrocytic anemia (defined as anemia with MCV > 100 fl) may be due to the deficiency of either cobalamin or folate. 14 …”

Section: Introductionmentioning

confidence: 99%

Burden and Determinants of Severe Anemia among HIV-Infected Adults

Makubi

Okuma

Spiegelman

et al. 2013

J Int Assoc Provid AIDS Care

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Background and Methods This cross-sectional study aimed at determining the prevalence and risk factors for severe anemia, severe microcytic anemia, and severe normocytic anemia among HIV-infected individuals aged >15 years. Univariate and multivariate analyses were performed to identify the risk factors for anemia. Results Data from 40 408 patients were analyzed, showing an overall prevalence of 22% for severe anemia. The risk of developing severe anemia increased by 49% among patients with a body mass index of <18.5 kg/m2, by approximately 2-fold among patients with the World Health Organization (WHO) stage III, and by 3-fold among patients with WHO stage IV illness. Severe normocytic anemia was uniquely increased among patients aged ≥50 years, among those with chronic diarrhea and Kaposi’s sarcoma, and those taking cotrimoxazole. Conclusion There was a high prevalence of severe anemia among adults infected with HIV. Focused identification of anemia should be based on the hemoglobin and mean corpuscular volume measurements.

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Anaemia in HIV-infected children: severity, types and effect on response to HAART

Cited by 36 publications

References 13 publications

Hematologic abnormalities and associated factors among HIV infected children pre- and post-antiretroviral treatment, North West Ethiopia

Hematologic abnormalities and associated factors among HIV infected children pre- and post-antiretroviral treatment, North West Ethiopia

<p>Predictors of Clinical and Immunological Failure Among Patients on First-Line Antiretroviral Therapy (ART) in Southwest Ethiopia</p>

Burden and Determinants of Severe Anemia among HIV-Infected Adults

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