Abstract
BackgroundAnemia is a common problem in HIV (human immunodeficiency virus) infected patients, and is associated with decreased functional capacity and quality of life. Ethiopia is one of the countries which has expanded highly active antiretroviral treatment (HAART) over the past years. The effect of HAART on anemia among HIV remains inconsistent and inconclusive, particularly in children. This study thus aimed to synthesize the prevalence of anemia among HIV infected Ethiopian children and its association with HAART initiation.MethodsMEDLINE/PubMed, EMBASE, PsycINFO, Web of Science and Google scholar were used to identify 12 eligible studies reporting an association between anemia and HIV using a priori set criteria. PRISMA guideline was used to systematically review and meta-analysis these studies. Details of sample size, magnitude of effect sizes, including odds ratio (OR) and standard errors were extracted. Random-effects model was used to calculate the pooled estimates using STATA/SE version-14. I2 and meta-bias statistics assessed heterogeneity and publication bias of the included studies. Sub-group analyses, based on study designs, were also carried out.ResultsIn Ethiopia, the overall prevalence of anemia in HIV infected children was 22.3% (95% CI: 18.5–26.0%). The OR of anemia-HIV/AIDS comorbidity was 0.4 (95% CI, 0.2–0.5) in HAART initiated children as compared to non-initiated counterparts. Meta-bias and funnel plot detected no publication bias.ConclusionOn aggregate, anemia is a common comorbidity in pediatric HIV patients. HAART was significantly associated with a reduced anemia-HIV/AIDS comorbidity. Prompt start of HAART might help decreasing the prevalence of anemia and its subsequent complications.
Highlights
Anemia is a common problem in HIV infected patients, and is associated with decreased functional capacity and quality of life
Previous study conducted in southern Ethiopia shows a 4.2% HIV positive rate in infants, of whom 2.6% were born from mothers who were on preventive MTCT intervention [6]
Descriptive summary of the included full-text articles All the 12 studies representing 3524 children included in the present review provided data on prevalence of anemia among HIV infected children
Summary
Anemia is a common problem in HIV (human immunodeficiency virus) infected patients, and is associated with decreased functional capacity and quality of life. This study aimed to synthesize the prevalence of anemia among HIV infected Ethiopian children and its association with HAART initiation. Previous study conducted in southern Ethiopia shows a 4.2% HIV positive rate in infants, of whom 2.6% were born from mothers who were on preventive MTCT intervention [6]. This may indicate that the magnitude of MTCT has not significantly reduced, and the Wagnew et al BMC Infectious Diseases (2019) 19:1032 country’s plan to achieve zero MTCT has been facing numerous challenges. The Ethiopian Federal Ministry of Health (FMoH) has employed option B+ (testand-treat) prevention of mother-to-child-transmission (PMTCT), an approach to avoid new HIV infection in newborns. The preferred first line ART regimen for children is AZT or ABC + 3TC + EFV and the alternative first line ART regimen is AZT + 3TC + NVP or TDF + 3TC + EFV [7]
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