HIV-associated anemia in children: a systematic review from a global perspective

Calis, Job C. J.; Hensbroek, Michaël Boele van; Haan, Rob J. de; Moons, Pieter; Brabin, Bernard; Bates, Imelda

doi:10.1097/qad.0b013e3282fa759f

Cited by 73 publications

(85 citation statements)

References 98 publications

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“…Our study area covers the same area of Nepal, but all children in our study were negative for hepatitis B and hepatitis C. Hematologic manifestations, particularly cytopenias, are common manifestations of HIV infection and AIDS [17,18] . Anemia was the most common haematological abnormality at presentation in our study.…”

Section: Discussionmentioning

confidence: 99%

“…All HIV positive children below 18 years of age presenting to paediatric immunology clinic of BP Koirala Institute of Health Sciences, Dharan, Nepal during the study period were enrolled, followed up and studied. Ethical clearance was taken from institutional ethical review board.…”

Section: Methodsmentioning

confidence: 99%

“…Diagnosis of HIV was made by rapid diagnostic tests above 18 months of age and by two DNA PCR tests between 6 weeks to 18 months of age following WHO guideline for diagnosis of paediatric HIV as adopted by government of Nepal [2] . Clinical staging of HIV, use of ART and change of ART were based on the same guideline [2] .…”

Section: Methodsmentioning

confidence: 99%

“…Frequencies of symptoms and signs at presentation among 31 symptomatic cases are presented in Table 2. On assessment of nutritional status at presentation, no undernutrition, moderate undernutrition and severe undernutrition were present in 18 Table 3 shows routine investigation findings at presentation. …”

Section: Presenting Features (Symptoms and Signs)mentioning

confidence: 99%

See 3 more Smart Citations

Profile of HIV infected children: A hospital based study at Eastern Nepal

Poudel

Pokharel

Chitlangia

et al. 2014

Asian Pacific Journal of Tropical Disease

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Presenting Features (Symptoms and Signs)mentioning

confidence: 99%

See 2 more Smart Citations

Profile of HIV infected children: A hospital based study at Eastern Nepal

Poudel

Pokharel

Chitlangia

et al. 2014

Asian Pacific Journal of Tropical Disease

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“…1 The etiologies of anemia in HIV-infected children are multifactorial, including HIV itself, micronutrient deficiency, particularly iron deficiency anemia (IDA), opportunistic infections, thalassemia, and anemia of chronic disease (ACD). 2 Moreover, the prevalences of anemia and IDA are higher in children in tropical countries than in children in western countries, 1 especially children with advanced HIV disease.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Anemia and Underlying Iron Status in Naive Antiretroviral Therapy HIV-Infected Children with Moderate Immune Suppression

Kosalaraksa

Bunupuradah

Saphonn³

et al. 2012

AIDS Research and Human Retroviruses

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Anemia is common in HIV-infected children and iron deficiency is thought to be a common cause. This study investigates the prevalence of anemia, thalassemia, and underlying iron status in Thai and Cambodian children without advanced HIV disease to determine the necessity of routine iron supplementation. Antiretroviral (ARV)-naive HIV-infected Asian children aged 1-12 years, with CD4 15-24%, CDC A or B, and hemoglobin (Hb) ‡ 7.5 g/dl were eligible for the study. Iron studies, serum ferritin, Hb typing, and C-reactive protein were assessed. Anemia was defined as Hb < 11.0 g/dl in children < 5 years of age or < 11.5 g/dl in children 5-12 years. We enrolled 299 children; 57.9% were female and the mean (SD) age was 6.3 (2.9) years. The mean (SD) CD4% and HIV-RNA were 20% (4.6) and 4.6 (0.6) log 10 copies/ml, respectively. The mean (SD) Hb and serum ferritin were 11.2 (1.1) g/dl and 78.3 (76.4) lg/liter, respectively. The overall iron deficiency anemia (IDA) prevalence was 2.7%. One hundred and forty-eight (50%) children had anemia, mostly of a mild degree. Of these, 69 (46.6%) had the thalassemia trait, 62 (41.8%) had anemia of chronic disease (ACD), 9 (6.1%) had thalassemia diseases, 3 (2.0%) had iron deficiency anemia, and 5 (3.4%) had IDA and the thalassemia trait. The thalassemia trait was not associated with increased serum ferritin levels. Mild anemia is common in ARV-naïve Thai and Cambodian children without advanced HIV. However, IDA prevalence is low; with the majority of cases caused by ACD. A routine prescription of iron supplement in anemic HIV-infected children without laboratory confirmation of IDA should be discouraged, especially in regions with a high prevalence of thalassemia and low prevalence of IDA.

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Treatment for anemia in people with AIDS

Martí‐Carvajal

Solà²,

Peña‐Martí

et al. 2011

Cochrane Database of Systematic Reviews

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This updated Cochrane review provides evidence that rHuEPO compared with placebo does not reduce mortality, does not reduce transfusion requirements, did not increase hemoglobin levels, and did not improve quality of life in HIV-infected patients with anemia. The results are based on six RCTs with high risk of bias. Therefore prescription of this intervention for treating anemia in patients with AIDS is not justified, unless new evidence from a large high quality trial alters this conclusion.

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HIV-associated anemia in children: a systematic review from a global perspective

Abstract: Anemia is a very common complication of pediatric HIV infection, associated with a poor prognosis. With the increasing global availability of highly active antiretroviral therapy, more data on the safety and efficacy of possible interventions in children are urgently needed.

Cited by 73 publications

References 98 publications

Profile of HIV infected children: A hospital based study at Eastern Nepal

Profile of HIV infected children: A hospital based study at Eastern Nepal

Prevalence of Anemia and Underlying Iron Status in Naive Antiretroviral Therapy HIV-Infected Children with Moderate Immune Suppression

Treatment for anemia in people with AIDS

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