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dc.contributor.authorKyeyune, Rachel
dc.contributor.authorSaathoff, Elmar
dc.contributor.authorEzeamama, Amara E
dc.contributor.authorLöscher, Thomas
dc.contributor.authorFawzi, Wafaie
dc.contributor.authorGuwatudde, David
dc.date.accessioned2014-10-09T18:10:40Z
dc.date.available2014-10-09T18:10:40Z
dc.date.issued2014-09-10
dc.identifier.citationBMC Infectious Diseases. 2014 Sep 10;14(1):496
dc.identifier.urihttp://dx.doi.org/10.1186/1471-2334-14-496
dc.identifier.urihttp://hdl.handle.net/10724/30550
dc.description.abstractAbstract Background Cytopenias are the most common HIV-associated hematological abnormality. Cytopenias have been associated with several factors including sex, race/ethnicity, geographical location and comorbidities such as tuberculosis, hepatitis B infection, fever and oral candidiasis. Cytopenias become more prevalent as HIV progresses and are often fatal. Data from resource-limited settings about the prevalence and correlates of cytopenia are limited. Therefore we conducted this cross-sectional study to assess the prevalence and correlates of cytopenia among adult AIDS patients at initiation of HAART in Uganda. Methods 400 HIV-infected subjects who were HAART-naïve or on HAART for ≤ 6 months were enrolled into the Multivitamins, HAART and HIV/AIDS Trial. Anemia was defined according to WHO guidelines as any hemoglobin concentration < 12 g/dl for non-pregnant females and < 13 g/dl for males. Leucopenia and thrombocytopenia were defined using study site laboratory reference ranges for lack of generally accepted definitions for these 2 cell lines as leucopenia if white blood cell count < 2.75 × 109 cells/litre and thrombocytopenia if platelets < 125 × 109 cells/litre for females and < 156 × 109 cells/litre for males. Univariate and bivariate analyses were done to describe the patient population and log-binomial regression was used to quantify the correlates of cytopenia. Results Sixty five percent of the 400 subjects had at least one form of cytopenia. Anemia occurred in 47.8%, leucopenia in 24.3%, thrombocytopenia in 8.3%, bicytopenia in 21.9% and only 2 had a pancytopenia. Cytopenia was more prevalent in females (prevalence ratio [PR]:1.33, 95% confidence interval [CI]:1.12-1.59); CD4 count category 50 to <200 (PR: 0.75, 95% CI: 0.64 -0.88) and CD4 count category 200 to <350 (PR: 0.74, 95% CI: 0.59 - 0.92) compared to CD4 count category <50; normal BMI (PR: 0.82, 95% CI:0.68-1.00) and overweight BMI (PR: 0.64, 95% CI:0.50- 0.82) compared to underweight BMI and those with a history or presence of oral candidiasis. Conclusions Cytopenias are a frequent complication in HIV-infected adults at initiation of HAART in Uganda. The presence of any cytopenia was associated with female sex, decreasing CD4 count and decreasing body mass index. Prospective studies in resource-limited settings on the trend in HIV-related cytopenias are needed.
dc.titlePrevalence and correlates of cytopenias in HIV-infected adults initiating highly active antiretroviral therapy in Uganda
dc.typeJournal Article
dc.date.updated2014-09-13T07:07:34Z
dc.description.versionPeer Reviewed
dc.language.rfc3066en
dc.rights.holderRachel Kyeyune et al.; licensee BioMed Central Ltd.


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