Hematological and immunological abnormalities among children receiving highly active antiretroviral therapy at Hawassa University College of Medicine and Health Sciences, Southern Ethiopia

Abstract

Background: The human immunodeficiency virus (HIV) epidemic remains a serious challenge and continues to take its roll, on vulnerable populations such as children. Hematological and immunological abnormalities are common complications in children infected with human immunodeficiency virus. They are associated with an increased risk of disease progression and death. Hence; specific diagnosis and determination of these parameters are required for monitoring of treatment to avert disease progression. Therefore, this study was aimed to determine hematological and immunological parameters among HAART-experienced children at Hawassa University comprehensive specialized Hospital. METHODS A hospital-based cross-sectional study was conducted among 273 HIV-infected children from July to December 2019. Data were collected using a structured questionnaire that included variables related to sociodemographic characteristics and clinical conditions of the study individuals. Blood samples for hematological and immunological parameters were collected and analyzed using SPSS version 20. P-Value < 0.05 considered statistically significant.RESULTSA total of 273 HAART-experienced children were enrolled. Of whom 139 (50.9%) and 134 (49.1%) were females and males respectively. The baseline means hemoglobin level of the study participants was 12mg/dl and 40.7% of children were anemic. A baseline CD4+ T-cell median percentage was 18.4% and increased to 29.2% and the mean hemoglobin level at baseline was 12 mg/dl and increased to 13.1mg/dl after treatment. The prevalence of anemia, thrombocytopenia, Leucopenia, Pancytopenia, and neutropenia was 11.4, 4%, 14.3%, 2.9%, and 18.3%, respectively. All forms of hematological abnormalities were highly prevalent in children with a CD4-cell percentage <15%. It was statistically significant with leucopenia (P=0.02), Leucocytosis (P=0.02), and lymphopenia (P=0.001). Similarly, they were highly prevalent with children who had a viral load greater than 150 viral copies /mm3. It was statistically significant with anemia (P=0.002), Lymphopenia (P=<0.001), and pancytopenia (P=0.001).Prevalence of anemia (25%) and Leucocytosis (18.8%) were high among children of age group <5 years.CONCLUSION:Hematologic and immunological abnormalities were common problems among children taking highly active antiretroviral therapy. Therefore, clinicians need to routinely investigate for hematological and immunological changes with appropriate therapeutic interventions for hematological and immunological abnormalities after treatment. Furthermore, large scale and longitudinal studies are recommended to strengthen and explore the problem in-depth

The prevalence of thrombocytopenia and leucopenia among people living with HIV/AIDS in Ethiopia: A systematic review and meta-analysis

“…[ 19 ] from Amhara regional state in 2019 (18.66%) and the lowest was reported by Fenta et al . [ 20 ] from SNNPR in 2020 (4%). The highest prevalence of leukopenia was reported by Enawgaw et al .…”

Global Prevalence and Associated Clinical Markers of Thrombocytopenia in People Living with HIV: Evidence from Meta-Analysis

“…There were 6686 patients in total among 12 studies who were eligible. These studies were published from 2014 to 2021 and were conducted in Ethiopia ( n = 8, 9.2% [ 1 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]), Cameroon ( n = 1, 19% [ 25 ]), China ( n = 1, 15.55%; [ 26 ]), Tanjaznia ( n = 1, 14.44% [ 27 ]), and Uganda ( n = 1, 8.25% [ 28 ]). Figure 2 shows additional quality scores for included studies.…”

“…The reported prevalence of thrombocytopenia in HIV patients varied from 4.03% to 19.03%. The lowest and highest prevalence of thrombocytopenia were 4.03% [ 22 ] and 19.03% [ 25 ], from Ethiopia and Cameroon, respectively.…”

“…In the study conducted by [ 22 ], mean age was 10.2 ± 3.2 years and CD4 + T > 350 cells/μL. Despite this, 73.7% were within 30–49 years of age, almost 51% of their CD4 + T levels were found to be >500 cells/μL, and only 13% of their CD4 + T levels were <200 cells/μL.…”

“… Pooled prevalence of thrombocytopenia among 6686 HIV patients from 12 studies [ 1 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ]. …”