PMID- 36052537
OWN - NLM
STAT- MEDLINE
DCOM- 20221118
LR  - 20231202
IS  - 1473-5571 (Electronic)
IS  - 0269-9370 (Print)
IS  - 0269-9370 (Linking)
VI  - 36
IP  - 15
DP  - 2022 Dec 1
TI  - Risk factors and prognostic significance of anemia in children with HIV infection 
      on antiretroviral therapy.
PG  - 2139-2146
LID - 10.1097/QAD.0000000000003374 [doi]
AB  - OBJECTIVES: To establish the incidence, risk factors and prognostic effect of 
      anemia in children living with HIV (CLWH). DESIGN: Retrospective nested 
      case-control study of patients 0-18 years in five centers in sub-Saharan Africa, 
      2004-2014. METHODS: Incident cases of anemia were identified from electronic 
      records and matched with CLWH without anemia. We calculated the incidence density 
      of anemia and used conditional logistic regression to evaluate its association 
      with risk factors, stratified by severity and type of anemia. We used a Cox 
      proportional hazards model to evaluate the impact of anemia on survival. RESULTS: 
      Two thousand, one hundred and thirty-seven children were sampled. The incidence 
      density of anemia was 1 per 6.6 CLWH-years. Anemia was moderate in 31.8% and 
      severe in 17.3% of anemia cases, which had 10-year mortality hazards of 3.4 and 
      4.5, respectively. Microcytic anemia (36% cases) was associated with 2.3-fold 
      hazard of 10-year mortality, and with malnutrition and CD4 + suppression. 
      Normocytic anemia (50.5% cases) was associated with 2.6-fold hazards of 10-year 
      mortality, and with more severe malnutrition, CD4 + suppression, and WHO stage, 
      but inversely associated with lamivudine and nevirapine therapy. Macrocytic 
      anemia (13.5% cases) was neither associated with higher 10-year mortality nor 
      with severe malnutrition or CD4 + suppression but was associated with WHO stage 
      II/III and negatively associated with lamivudine therapy. CONCLUSION: This large 
      multicountry study of CLWH found a high incidence density of anemia. Higher 
      severity, normocytic and microcytic types of anemia were independently associated 
      with long-term mortality. Laboratory studies are needed to decipher the 
      mechanisms of anemia and how it impacts mortality in CLWH.
CI  - Copyright (c) 2022 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Lubega, Joseph
AU  - Lubega J
AD  - Baylor College of Medicine.
FAU - Grimes, Amanda
AU  - Grimes A
AD  - Baylor College of Medicine.
FAU - Airewele, Gladstone
AU  - Airewele G
AD  - Baylor College of Medicine.
FAU - Bulsara, Shaun
AU  - Bulsara S
AD  - Baylor College of Medicine.
FAU - Kim, Taylor Olmsted
AU  - Kim TO
AD  - Baylor College of Medicine.
FAU - Haq, Heather
AU  - Haq H
AD  - Baylor College of Medicine.
FAU - Peckham-Gregory, Erin
AU  - Peckham-Gregory E
AD  - Baylor College of Medicine.
FAU - Wanless, Sebastian R
AU  - Wanless SR
AD  - Baylor International Pediatric AIDS Initiative, Houston, Texas, USA.
FAU - Elyanu, Peter
AU  - Elyanu P
AD  - Baylor College of Medicine.
FAU - Musoke, Philippa
AU  - Musoke P
AD  - Makerere University.
FAU - Lumumba, Mwita
AU  - Lumumba M
AD  - Baylor International Pediatric AIDS Initiative, Houston, Texas, USA.
FAU - Kekitiinwa, Adeodata
AU  - Kekitiinwa A
AD  - Baylor International Pediatric AIDS Initiative, Houston, Texas, USA.
FAU - Matshaba, Mogomotsi
AU  - Matshaba M
AD  - Baylor International Pediatric AIDS Initiative, Houston, Texas, USA.
FAU - Despotovic, Jenny
AU  - Despotovic J
AD  - Baylor College of Medicine.
FAU - Scheurer, Michael
AU  - Scheurer M
AD  - Baylor College of Medicine.
LA  - eng
GR  - P30 CA125123/CA/NCI NIH HHS/United States
GR  - U54 CA254569/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20220831
PL  - England
TA  - AIDS
JT  - AIDS (London, England)
JID - 8710219
RN  - 2T8Q726O95 (Lamivudine)
SB  - IM
MH  - Child
MH  - Humans
MH  - *HIV Infections/complications/drug therapy/epidemiology
MH  - Lamivudine
MH  - Prognosis
MH  - Retrospective Studies
MH  - Case-Control Studies
MH  - *Anemia/complications/epidemiology
MH  - Risk Factors
MH  - *Malnutrition
PMC - PMC9671853
MID - NIHMS1832748
COIS- Conflicts of Interest The authors declare no conflict of interest.
EDAT- 2022/09/03 06:00
MHDA- 2022/11/19 06:00
PMCR- 2023/12/01
CRDT- 2022/09/02 03:43
PHST- 2022/09/03 06:00 [pubmed]
PHST- 2022/11/19 06:00 [medline]
PHST- 2022/09/02 03:43 [entrez]
PHST- 2023/12/01 00:00 [pmc-release]
AID - 00002030-202212010-00007 [pii]
AID - 10.1097/QAD.0000000000003374 [doi]
PST - ppublish
SO  - AIDS. 2022 Dec 1;36(15):2139-2146. doi: 10.1097/QAD.0000000000003374. Epub 2022 
      Aug 31.