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贫血对感染艾滋病毒的儿科患者预后的影响:一项前瞻性观察研究。

Impact of Anemia on Outcome of HIV-Infected Pediatric Patients: A Prospective Observational Study.

作者信息

Bhaisara Baraturam Bhagrati, Gajre Mona, Manglani Mamta, Wade Minal, Sharma Sujata

机构信息

Department of Pediatrics, HBT Medical College & Dr R N Cooper Municipal General Hospital, Mumbai, Maharashtra, India.

Department of Pediatrics, LTMMC and LTMGH, Sion, Mumbai, Maharashtra, India.

出版信息

Indian J Community Med. 2019 Apr-Jun;44(2):152-156. doi: 10.4103/ijcm.IJCM_326_18.

Abstract

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, -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/mm was lower (7.90 g%) (standard deviation 1.48) compared to those having CD4 >350 cell/mm ( = 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.

摘要

引言

贫血已被广泛报道可预测HIV感染患者的预后较差,无论是在进展为艾滋病方面还是在生存方面。本研究旨在确定HIV感染儿童贫血的病因及其免疫相关性。

材料与方法

对489名HIV感染儿童进行筛查,其中86名贫血的HIV感染儿童被纳入研究。采用世界卫生组织的标准定义来界定贫血、HIV分期和生长参数。使用卡方检验、t检验以及单变量和多变量逻辑回归分析来分析数据。

结果

17.58%(86/489)的HIV感染儿童存在贫血,其中84.6%为中度贫血,11.5%为重度贫血,2.32%为轻度贫血。CD4细胞计数<350个/mm³的患者平均血红蛋白(Hb)水平(7.90 g%)(标准差1.48)低于CD4细胞计数>350个/mm³的患者(P = 0.02)。与免疫状态正常的儿童相比,处于严重免疫阶段的儿童平均Hb水平显著更低(调整估计值:-1.61,95%置信区间:-2.65,-0.56)。在未调整和调整后的回归模型中,与各种人口统计学和临床特征相比,基线时的平均Hb水平无统计学显著差异。

结论

Hb是一种易于测量且成本低廉的工具,可用于在资源有限的环境中监测疾病进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74a1/6625266/e1e5e2a7517f/IJCM-44-152-g001.jpg

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