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Impact of Anemia on Outcome of HIV-Infected Pediatric Patients: A Prospective Observational Study
Baraturam Bhagrati Bhaisara1, Mona Gajre2, Mamta Manglani2
1Department of Pediatrics, HBT Medical College & Dr R N Cooper Municipal General Hospital, Mumbai, Maharashtra, India.
Insights
Anemia affects over 17% of HIV-infected children, with lower hemoglobin linked to severe immune deficiency. Hemoglobin monitoring is crucial for disease progression in resource-limited settings.
Area of Science:
- Pediatric infectious diseases
- Hematology
- Immunology
Background:
- Anemia is a known predictor of poor prognosis in HIV-infected individuals, impacting both AIDS progression and survival.
- Understanding the causes and immunological links of anemia in children with HIV is critical for effective management.
Purpose of the Study:
- To determine the etiology of anemia in HIV-infected children.
- To investigate the immunological correlations of anemia in this population.
Main Methods:
- Screened 489 HIV-infected children, enrolling 86 with anemia.
- Utilized standard WHO definitions for anemia, HIV staging, and growth parameters.
- Employed Chi-square, t-tests, and logistic regression for data analysis.
Main Results:
- Anemia was identified in 17.58% of HIV-infected children, predominantly moderate to severe.
- Lower mean hemoglobin levels were observed in children with CD4 counts <350 cells/mm³ (P=0.02).
- Severe immunodeficiency correlated with significantly lower mean hemoglobin (adjusted estimate: -1.61).
Conclusions:
- Hemoglobin is a valuable, cost-effective tool for monitoring disease progression in HIV-infected children.
- This highlights the importance of anemia screening and management in pediatric HIV care, especially in resource-limited settings.
Introduction:
Anemia has been widely reported to predict a poorer prognosis for HIV-infected patients, both in terms of progression to AIDS and in survival. This study aimed to determine the etiology of anemia and its immunological correlation in HIV-infected children.
Materials And Methods:
Four hundred and eighty-nine HIV-infected children were screened, of which 86 HIV-infected children with anemia were enrolled. Standard WHO definitions were used for anemia, HIV staging, and growth parameters. Chi-square test, t-tests, and univariate and multivariate logistic regression analyses were used to analyze the data.
Results:
Anemia was present in 17.58% (86/489) of HIV-infected children, including 84.6% with moderate anemia, 11.5% with severe anemia, and 2.32% with mild anemia. The mean hemoglobin (Hb) among patients with CD4 count <350 cell/mm3 was lower (7.90 g%) (standard deviation 1.48) compared to those having CD4 >350 cell/mm3 (P = 0.02). Children with severe immunological stage had a significantly lower mean Hb (adjusted estimate: -1.61, 95% confidence interval: -2.65, -0.56) compared to those who had normal immune status. No statistically significant differences in mean Hb at baseline when compared to various demographic and clinical characteristics were observed in unadjusted and adjusted regression models.
Conclusion:
Hb is an easy and inexpensive tool to measure and can be used for monitoring disease progression in a resource-limited setting.
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