Anaemia in HIV infected HAART naïve and HAART exposed children

Abstract

Background: The 2016 UNAIDS report estimates about 2.1 million people living with HIV in India, of whom about 7 per cent are children under the age of 15 year. The primary objective of this study was to analyze the prevalence of anaemia in HIV Infected HAART naïve and HAART exposed children. The secondary objectives were to analyze the type of anaemia and correlation of anaemia with dietary habits and associated opportunistic infections. Present study was a cross-sectional, observational study carried out in pediatric ART OPD and ward of a tertiary care teaching hospital, from June 2011 to May 2013.Methods: Complete haemogram, peripheral smear and CD4 counts were done on 130 children with confirmed diagnosis of HIV infection. CDC staging was used to stratify children. We used Chi square test to determine the association between CDC staging, HAART therapy, diet and opportunistic infection with anaemia. P-value <0.05 was taken as significant.Results: 80% (n = 27) of the children with no immunosuppression, 86% (n = 58) of the children with moderate immunosuppression and 84% (n = 24) children with severe immunosuppression were anemic. There was no statistically significant relation between worsening immunosuppression and prevalence of anaemia (p = 0.715). 88% of the children with no opportunistic infection (n = 72) were anemic, while 76% (n = 34) children with opportunistic infection were anemic. This difference was statistically significant (p = 0.016). 88% (n = 53) of the children on HAART were anemic while 74% (n = 51) of the children not on HAART were anemic. Children on HAART did not have significantly high prevalence of anaemia when compared to children not on HAART (p = 0.99). Anaemia was significantly more common in children consuming vegetarian diet (88%, n = 46) compared to children consuming mixed diet (74%, n = 58, p <0.01).Conclusions: Prevalence of anaemia is similar in children on HAART compared to HAART naïve children and at all stages of immunosuppression. Anaemia was more common in the presence opportunistic infections and in children consuming vegetarian diet. Microcytic hypochromic anemia was most common type of anaemia followed by normocytic normochromic anaemia.