Magnitude and Factors Associated with Cytopenia Among Children on Highly Active Antiretroviral Therapy at Hawassa University College of Medicine and Health Science, Sidama Region, Southern Ethiopia.
Metsihet Mohammed Nuru, Temesgen Bizuayehu Wube, Demissie Assegu Fenta
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Abstract
Background: The most common abnormality in HIV-infected children is cytopenia, a hematological complication characterized by a decline in any of the blood cell lines. It is associated with a higher risk of morbidity and mortality. Therefore, this study aimed to assess the prevalence and associated factors of cytopenia among HIV-positive children on highly active antiretroviral therapy (HAART).
Methods: Hospital-based cross-sectional study design was conducted on HIV-positive children on HAART from July to September 2020. Socio-demographic and clinical characteristics of the study participants' data were collected using a structured questionnaire. Hematological parameters from the blood sample were analyzed using Ruby Cell-Dyne 300 hematology auto-analyzer. The data were analyzed using SPSS version 20. Logistic regression was used to assess the predictors of cytopenia among the study participants. P-values of less than 0.05 are considered statistically significant.
Results: Two hundred seventy-three HAART-experienced children were enrolled in this study, and 50.9% were females. At baseline, 40.7% of children were anemic. The overall magnitude of cytopenia among the study participants was 26.7%. The prevalence of anemia, thrombocytopenia, leucopenia and neutropenia among children was 11.4%, 4.0%, 14.3%, and 18.3%, respectively. Patients with an undetectable viral load (AOR = 0.5, CI = 0.3-0.9) are 50% less likely to report cytopenia. HAART-experienced children living in rural areas are more likely to develop cytopenia (AOR = 2.6, CI = 1.3-5.2) than those living in urban areas.
Conclusion: Hematologic abnormalities are common problems among children on highly active antiretroviral therapy. Therefore, routine investigation of hematological and immunological changes following appropriate therapeutic interventions is recommended.
背景:hiv感染儿童中最常见的异常是血细胞减少，这是一种血液学并发症，其特征是任何一种血细胞的减少。它与较高的发病率和死亡率有关。因此，本研究旨在评估在接受高效抗逆转录病毒治疗(HAART)的hiv阳性儿童中细胞减少的患病率及其相关因素。方法:对2020年7月至9月在医院接受HAART治疗的hiv阳性儿童进行横断面研究设计。使用结构化问卷收集研究参与者的社会人口学和临床特征数据。使用Ruby Cell-Dyne 300血液学自动分析仪分析血样的血液学参数。数据采用SPSS version 20进行分析。Logistic回归用于评估研究参与者中细胞减少的预测因素。p值小于0.05被认为具有统计学意义。结果:273名经历过haart治疗的儿童被纳入本研究，其中50.9%为女性。在基线时，40.7%的儿童贫血。研究参与者中细胞减少的总体程度为26.7%。儿童贫血、血小板减少、白细胞减少和中性粒细胞减少的患病率分别为11.4%、4.0%、14.3%和18.3%。无法检测到病毒载量的患者(AOR = 0.5, CI = 0.3-0.9)报告细胞减少的可能性要低50%。生活在农村地区经历过haart治疗的儿童比生活在城市地区的儿童更容易发生细胞减少症(AOR = 2.6, CI = 1.3-5.2)。结论:在接受高效抗逆转录病毒治疗的儿童中，血液学异常是常见问题。因此，建议在适当的治疗干预后进行血液学和免疫学的常规检查。
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