Magnitude and associated factors of cytopenias among antiretroviral therapy naïve Human Immunodeficiency Virus infected adults in Dessie, Northeast Ethiopia

Abstract

Background Hematologic abnormalities involving peripheral blood cell cytopenias are strong predictors of morbidity, mortality and poor antiretroviral therapy (ART) outcomes of HIV infected individuals. However, limited studies are conducted in resource-limited settings of sub-Saharan Africa that have addressed the magnitude and associated factors of cytopenias. This study aimed to investigate the magnitude and associated factors of cytopenias among ART naïve HIV infected adult Ethiopians. Materials and methods A cross-sectional study was conducted among ART naïve HIV infected individuals attending at ART unit of Dessie Referral Hospital between November 01, 2015 and April 30, 2016. A total of 402 adults were included using consecutive sampling. Socio-demographic, clinical and laboratory data of patients were collected. The data were entered to Epi Info version 3.4.3 and analyzed using SPSS version 20 software (SPSS INC, Chicago, IL, USA). Factors associated with cytopenias were analyzed first using bivariate and then multivariate logistic regression models. An odds ratio with 95% confidence interval was used to measure the strength of association. For all statistical significant tests, the cut-off value was set at P<0.05. Results In this study, the overall magnitude of any cytopenia, anemia, leucopenia and thrombocytopenia were 63.4%, 43.5%, 24.4% and 18.7%, respectively. In multivariate logistic regression analysis, severe immunosuppression and WHO clinical stage IV HIV disease were significantly associated with increased prevalence of cytopenias. In addition, older age and younger age showed significant association with increased prevalence of anemia and leucopenia, respectively. Conclusion Frequent occurrence of cytopenias was independently associated with severe immunosuppression and WHO clinical stage IV HIV disease. Further longitudinal multicenter studies are recommended to bolster the findings of this study in order to suggest the need of routine assessment and management of hematological abnormalities for optimal choice of initial antiretroviral agents and prevention of further morbidities.

Hematologic alterations and early mortality in a cohort of HIV positive African patients

“…As other authors already observed [23], a comprehensive haematologic analyses showed the high prevalence of one or more cytopenia of any type (40,1%) in patients with severe HIV disease. In our opinion, however, this is only one aspect of the problem.…”

Prevalence of cytopenia and its associated factors among HIV infected adults on highly active antiretroviral therapy at Mehal Meda Hospital, North Shewa Zone, Ethiopia

“…As anemia, there is no generally accepted cut-offs for leucopenia and thrombocytopenia; we defined them as used in other studies [19,27]. Leucopenia was defined as a total WBC < 4.0 × 103/μL, whereas thrombocytopenia was defined as a total platelet count < 150 × 103/μL.…”

<p>Anemia and Associated Factors Among Adults with Human Immune Deficiency Virus on Antiretroviral Therapy in Public Health Facilities of Kembata Tembaro Zone, Southern Ethiopia: A Cross-Sectional Study</p>

“…5,7,11 Previous studies conducted in Ethiopia reported the magnitude of anemia among adult HIV patients on ART ranges from 23-43.5%. 13,20 Being female, illiterate, or ART naïve; having a history of taking anti-TB treatment; taking a Zidovudine (ZDV)-containing ART regimen; CD4+ T-lymphocyte count; nutritional status; body mass index (BMI); and WHO clinical stage of HIV/AIDS are important factors associated with the occurrence of anemia among adults HIV patients on ART. 13,18 Despite the widely divergent socioeconomic factors that characterize HIV worldwide, the degree of clinical anemia remains an independent risk factor for predicting mortality from HIV, even upon initiation of therapy.…”