Department of Hematology and Immunohematology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
PLoS One. 2021 Mar 2;16(3):e0247878. doi: 10.1371/journal.pone.0247878. eCollection 2021.
Isolated or multi lineage cytopenia are the most common clinicopathological features and independently associated with increased risk of disease progression and death among human immunodeficiency virus infected children. In the study area, there is scarcity of data about the magnitude of various cytopenia.
Aimed to determine the magnitude and associated factors of peripheral cytopenia among HIV infected children at the University of Gondar Specialized Referral Hospital ART clinic, Northwest Ethiopia.
Institutional based cross-sectional study was conducted on 255 HIV infected children from January- April 2020. None probable convenient sampling technique was used to select the study participant. Socio demographic data were collected by pre tested structured questionnaire via face-to-face interview and their medical data were obtained from their follow-up medical records. Moreover, blood specimens were collected and examined for complete blood count, viral load and blood film, whereas stool specimens were collected and examined for intestinal parasites. Bi-variable and multi-variable logistic regression models were fitted to identify associated factors of cytopenia. P-Value <0.05 was considered as statistically significant.
The overall magnitude of peripheral cytopenia was 38.9%. Anemia, leukopenia, lymphopenia, thrombocytopenia and bi-cytopenia were 21.2%, 12.2%, 11%, 1.6% and 3.9% respectively. Being in the age group of 2-10 years (AOR = 5.38, 95%CI 2.33-12.46), AZT based regimen (AOR = 5.44, 95%CI: 2.24-13.21), no eating green vegetables (AOR = 2.49, 95% CI: 1.26-4.92) and having plasma viral load >1000 copies /ml (AOR = 5.38, 95%CI: 2.22-13.03) showed significant association with anemia.
Anemia was the predominant peripheral cytopenia among HIV infected children in this study. It was strongly associated with AZT based drug type, age below 10 years and high viral load. Critical stress should be given for early investigation and management of cytopenia in addition to the use of alternative drug which leads to higher viral suppression and lower risk of toxicity issue.
孤立性或多谱系细胞减少症是最常见的临床病理特征，并且独立与人类免疫缺陷病毒感染儿童的疾病进展和死亡风险增加相关。在研究区域，关于各种细胞减少症的严重程度的数据稀缺。
旨在确定在埃塞俄比亚西北部贡德尔大学专科转诊医院 ART 诊所感染 HIV 的儿童外周血细胞减少症的程度和相关因素。
2020 年 1 月至 4 月，对 255 名感染 HIV 的儿童进行了基于机构的横断面研究。采用无概率方便抽样技术选择研究对象。通过面对面访谈，使用预先测试的结构化问卷收集社会人口统计学数据，并从随访病历中获取他们的医疗数据。此外，采集血样进行全血细胞计数、病毒载量和血片检查，采集粪便标本进行肠道寄生虫检查。采用双变量和多变量逻辑回归模型来确定细胞减少症的相关因素。P 值<0.05 被认为具有统计学意义。
外周血细胞减少症的总发生率为 38.9%。贫血、白细胞减少症、淋巴细胞减少症、血小板减少症和双细胞减少症分别为 21.2%、12.2%、11%、1.6%和 3.9%。年龄在 2-10 岁之间（AOR=5.38，95%CI 2.33-12.46）、AZT 为基础的方案（AOR=5.44，95%CI：2.24-13.21）、不吃绿色蔬菜（AOR=2.49，95%CI：1.26-4.92）和血浆病毒载量>1000 拷贝/ml（AOR=5.38，95%CI：2.22-13.03）与贫血显著相关。
贫血是本研究中 HIV 感染儿童最常见的外周血细胞减少症。它与 AZT 为基础的药物类型、10 岁以下的年龄和高病毒载量密切相关。除了使用能提高病毒抑制率和降低毒性问题风险的替代药物外，还应高度重视外周血细胞减少症的早期调查和管理。
