A prospective, cross-sectional study of anaemia and peripheral iron status in antiretroviral naïve, HIV-1 infected children in Cape Town, South Africa

Eley, Brian; Sive, Alan; Shuttleworth, Margaret H G; Hussey, Gregory

doi:10.1186/1471-2334-2-3

Cited by 56 publications

(42 citation statements)

References 15 publications

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“…Before initiation of ART in children, anemia in this study (54.4%) was almost as prevalent in the subjects as in a similar study done in Jimma, Ethiopia (53.1%),7 but it was less common than in reports from India (66%) and South Africa (73%) 12,13. Prevalence of anemia was higher among the preschool children in the current study.…”

Section: Discussionsupporting

confidence: 50%

Prevalence of anemia and nutritional status among HIV-positive children receiving antiretroviral therapy in Harar, eastern Ethiopa

Teklemariam¹,

Mitiku²,

Mesfin³

2015

HIV

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PurposeAnemia and growth retardation are common manifestations of HIV-positive children, which threaten their lives. Therefore, this study tried to assess the burden of anemia and the nutritional status of HIV-positive children receiving antiretroviral therapy (ART) in eastern Ethiopa.Patients and methodsA total of 108 records of children on ART followed up in Hiwot Fana Specialized University Hospital from 2007 to 2010 were retrospectively reviewed from November 1 to November 30, 2011.ResultsApproximately 54.4% of the children had been anemic before the initiation of their ART (at baseline): 7.8% were severely anemic and 44.7% were moderately anemic. These percentages were higher in preschool children than in school children (adjusted odds ratio [AOR]: 4.80 [95% confidence interval {CI}: 1.96, 11.75]), and were higher in males than in females (AOR: 2.61 [95% CI: 1.06, 6.45]). The prevalence of anemia was reduced to 39.2% 1 year after initiation of ART. The increasing of hemoglobin values was highly significant for both zidovudine (AZT)- and stavudine (d4T)-based ART (P<0.05). At baseline, 51.6% of the study subjects were underweight (weight-for-age Z score less than −2 standard deviation [SD]); 49.1% were stunted (height-for-age Z score less than −2 SD); and 31.5% were wasted (body mass index less than −2 SD), which, after a year on ART, declined to 8.9%, 15.9%, and 9.8%, respectively.ConclusionThere was high prevalence of anemia and growth failure among HIV-infected children in the study area. However, there was a decline after initiation of ART. Therefore, adherence counseling to strengthen the uptake of ART is recommended. Moreover, large-scale, prospective studies should be done to understand the magnitude and etiology of the problems with HIV-negative control groups.

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Section: Discussionsupporting

confidence: 50%

Prevalence of anemia and nutritional status among HIV-positive children receiving antiretroviral therapy in Harar, eastern Ethiopa

Teklemariam¹,

Mitiku²,

Mesfin³

2015

HIV

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“…Few studies among HIVinfected children have comprehensively examined the causes of anemia in this population. In the South African study where ferritin<10 μg/dl was used to define iron depletion, 45% of all anemic toddlers were found to be iron depleted, although the remaining causes of anemia were not studied [9]. Interestingly in this study, the prevalence of iron deficiency alone was also high at 52%.…”

Section: Anemia and Nutritional Deficienciesmentioning

confidence: 66%

“…A Ugandan study among ART-naive young infants with HIV reported that 92% had anemia at baseline, and 100% developed anemia over the succeeding 3 years [6]. A study of HIV-infected toddlers between ages 1 and 3 years in South Africa reported an anemia prevalence of 73% [9], while a Malawian study indicated that 78% of 12-month-old HIV-infected infants had anemia [40]. The inclusion of children older than 2 years and the presence of ART may explain the lower prevalence of anemia seen in our study.…”

Section: Anemia and Hiv Infectionmentioning

confidence: 96%

The prevalence and etiology of anemia among HIV-infected children in India

et al. 2011

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“…31 Iron deficiency is highly prevalent (18.0-44.3%) in developing countries, 3,29 but not in this study. The high prevalences of IDA in other studies might be the result of the inclusion of children with poorer nutritional status and more severe clinical stage of HIV.…”

Section: Discussionmentioning

confidence: 83%

“…13 IDA [3][4][5][6][7][8][9][10][11][12][13][14][15] was defined as anemia with (1) serum ferritin < 10 lg/ml if CRP was < 10 mg/liter or serum ferritin < 50 lg/ml if CRP was ‡ 10 mg/liter 16,17 and (2) having at least three of the following five parameters: (1) SI < 8.8 lmol/liter, (2) TIBC > 71.6 lmol/liter, (3) TS < 10%, (4) mean corpuscular volume (MCV) less than normal age-related values ( < 2 years = 78 fl, ‡ 2 years = 81 fl), or (5) mean corpuscular hemoglobin (MCH) less than normal age-related values ( < 2 years = 23 pg, 2-5 years = 24 pg, and ‡ 6 years = 25 pg). 14,15 Nonthalassemia was defined as having no common thalassemia mutations or deletions of a-and b-genes.…”

Section: Methodsmentioning

confidence: 99%

Prevalence of Anemia and Underlying Iron Status in Naive Antiretroviral Therapy HIV-Infected Children with Moderate Immune Suppression

Kosalaraksa

Bunupuradah

Saphonn³

et al. 2012

AIDS Research and Human Retroviruses

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Anemia is common in HIV-infected children and iron deficiency is thought to be a common cause. This study investigates the prevalence of anemia, thalassemia, and underlying iron status in Thai and Cambodian children without advanced HIV disease to determine the necessity of routine iron supplementation. Antiretroviral (ARV)-naive HIV-infected Asian children aged 1-12 years, with CD4 15-24%, CDC A or B, and hemoglobin (Hb) ‡ 7.5 g/dl were eligible for the study. Iron studies, serum ferritin, Hb typing, and C-reactive protein were assessed. Anemia was defined as Hb < 11.0 g/dl in children < 5 years of age or < 11.5 g/dl in children 5-12 years. We enrolled 299 children; 57.9% were female and the mean (SD) age was 6.3 (2.9) years. The mean (SD) CD4% and HIV-RNA were 20% (4.6) and 4.6 (0.6) log 10 copies/ml, respectively. The mean (SD) Hb and serum ferritin were 11.2 (1.1) g/dl and 78.3 (76.4) lg/liter, respectively. The overall iron deficiency anemia (IDA) prevalence was 2.7%. One hundred and forty-eight (50%) children had anemia, mostly of a mild degree. Of these, 69 (46.6%) had the thalassemia trait, 62 (41.8%) had anemia of chronic disease (ACD), 9 (6.1%) had thalassemia diseases, 3 (2.0%) had iron deficiency anemia, and 5 (3.4%) had IDA and the thalassemia trait. The thalassemia trait was not associated with increased serum ferritin levels. Mild anemia is common in ARV-naïve Thai and Cambodian children without advanced HIV. However, IDA prevalence is low; with the majority of cases caused by ACD. A routine prescription of iron supplement in anemic HIV-infected children without laboratory confirmation of IDA should be discouraged, especially in regions with a high prevalence of thalassemia and low prevalence of IDA.

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A prospective, cross-sectional study of anaemia and peripheral iron status in antiretroviral naïve, HIV-1 infected children in Cape Town, South Africa

Cited by 56 publications

References 15 publications

Prevalence of anemia and nutritional status among HIV-positive children receiving antiretroviral therapy in Harar, eastern Ethiopa

Prevalence of anemia and nutritional status among HIV-positive children receiving antiretroviral therapy in Harar, eastern Ethiopa

The prevalence and etiology of anemia among HIV-infected children in India

Prevalence of Anemia and Underlying Iron Status in Naive Antiretroviral Therapy HIV-Infected Children with Moderate Immune Suppression

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