Abstract
BackgroundHIV and anaemia are major health challenges in Africa. Anaemia in HIV-infected individuals is associated with more rapid disease progression and a poorer prognosis if not addressed appropriately. This study aimed at determining the severity and types of anaemia among HIV infected children and its effect on short term response to antiretroviral therapy (ART).MethodsAt baseline, clinical and haematological parameters of 257 HIV-infected ART-naïve children aged 3 months to 18 years were assessed to determine the prevalence, severity and types of anaemia. ART eligible patients were started on therapy according to WHO criteria, enrolled (n=88) into an observational cohort and followed up for 6 months.ResultsAnaemia was present in 148/257 (57.6%) of children, including (93/148) 62.2% with mild anaemia, 47/148 (32.0%) moderate anaemia, and 7/148 (4.8%) with severe anaemia. The mean haemoglobin (hb) was lower among children with more advanced HIV disease (p<0.0001). Microcytic-hypochromic anaemia (44.9%) was the commonest type of anaemia. Anaemia was independently associated with young age (p <0.0001), advanced HIV WHO disease stage (p = 0.034) and low CD4 percentage (p = 0.048). The proportion of children who had attained viral suppression (viral load <400 copies/ml) at 3 months was significantly lower among the anaemic children, 31/58 (53.4%) compared to the non-anaemic children 26/30 (86.7%) (p=0.002). However, the difference in clinical and immunological response between the anaemic and non-anaemic patients did not reach statistical significance.ConclusionAnaemia is highly prevalent among HIV-infected children in a rural Ugandan clinic and is associated with poorer virological suppression. However, the anaemia did not impact clinical and immunological response to ART among these children.
Highlights
HIV and anaemia are major health challenges in Africa
Anaemia has been recognized as an important clinical problem in HIV-infected patients [1,2,3] with an estimated prevalence ranging from 10% in asymptomatic HIV-infected patients to 92% in patients with AIDS [4,5]
This study described the prevalence, severity and types of anaemia among antiretroviral therapy (ART)-naïve HIV-infected children presenting at Mbarara Regional Referral Hospital (MRRH), a tertiary centre in western Uganda, and examined the effect of baseline anaemia on subsequent response to ART
Summary
HIV and anaemia are major health challenges in Africa. Anaemia in HIV-infected individuals is associated with more rapid disease progression and a poorer prognosis if not addressed appropriately. This study aimed at determining the severity and types of anaemia among HIV infected children and its effect on short term response to antiretroviral therapy (ART). Studies done earlier found an association between the presence of anaemia at baseline and decreased survival as well as increased disease progression in patients with HIV infection [7,8]. The effect of the presence of anaemia on response to ART in HIV-infected children has not been studied. This study described the prevalence, severity and types of anaemia among ART-naïve HIV-infected children presenting at Mbarara Regional Referral Hospital (MRRH), a tertiary centre in western Uganda, and examined the effect of baseline anaemia on subsequent response to ART
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