Incidence and predictors of severe anemia in Asian HIV-infected children using first-line antiretroviral therapy
Year: 2013
Type: article
Study design: Observational Study
Abstract: BACKGROUND: There are limited data on treatment-related anemia in Asian HIV-infected children. METHODS: Data from Asian HIV-infected children aged <18 years on first-line highly active antiretroviral therapy (HAART) were used. Children who had pre-existing severe anemia at baseline were excluded. Anemia was graded using the United States Division of AIDS (DAIDS) 2004 table. Potential risk factors for severe anemia were assessed by logistic regression. RESULTS: Data from 1648 children (51.9% female, 62.8% World Health Organization (WHO) stage 3/4) were analyzed. Median (interquartile range) age was 6.8 (3.7-9.6) years, CD4% was 9 (3-16)%, and plasma HIV-RNA was 5.2 (4.7-5.6) log10 copies/ml at HAART initiation in those with available testing. The most common regimens were stavudine/lamivudine/nevirapine (42%) and zidovudine/lamivudine/nevirapine (25%). Severe anemia was identified in 47 (2.9%) children after a median time of 6 months after HAART initiation, with an incidence rate of 5.4 per 100 child-years. Mild anemia or moderate anemia at baseline (p = 0.024 and p = 0.005, respectively), previous or current use of zidovudine (p < 0.0001 and p = 0.013, respectively), and male sex (p = 0.008) were associated with severe anemia. Higher weight-for-age z-score (p = 0.004) was protective. CONCLUSIONS: The incidence of severe anemia in Asian HIV-infected children after HAART initiation was low and mainly occurred during the first few months after HAART initiation. Mild to moderate anemia at baseline and using zidovudine were independent risk factors for the development of severe anemia.
Authors: Torsak Bunupuradah, Azar Kariminia, Kwai-Cheng Chan, Reshmie Ramautarsing, Bui Vu Huy, Ning Han, Revathy Nallusamy, Rawiwan Hansudewechakul, Vonthanak Saphonn, Virat Sirisanthana, Kulkanya Chokephaibulkit, Nia Kurniati, Nagalingeswaran Kumarasamy, Nik Khairulddin Nik Yusoff, Kamarul Razali, Siew Moy Fong, Annette H. Sohn, Pagakrong Lumbiganon
Institutions: Thai Red Cross Society, UNSW Sydney, HIV Netherlands Australia Thailand Research Collaboration, Kirby Institute, Hospital Pulau Pinang, Amsterdam UMC Location University of Amsterdam, Amsterdam Institute for Global Health and Development, University of Amsterdam, Vietnam National Children's Hospital, Beijing Ditan Hospital, ChiangRai Prachanukroh Hospital, National Center for HIV/AIDS, Dermatology and STD, Chiang Mai University, Siriraj Hospital, Mahidol University, Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo, YR Gaitonde Centre for AIDS Research and Education, Hospital Raja Perempuan Zainab II, Hospital Kuala Lumpur, American Foundation for AIDS Research, Khon Kaen University
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,900
OpenAlex ID: W1968607461