Anaemia in HIV-infected children: severity, types and effect on response to HAART

At baseline, clinical and haematological parameters of 257 HIV-infected ART-na？ve children aged 3 months to 18 years were assessed to determine the prevalence, severity and types of anaemia. ART eligible patients were started on therapy according to WHO criteria, enrolled (n=88) into an observational cohort and followed up for 6 months.Anaemia was present in 148/257 (57.6%) of children, including (93/148) 62.2% with mild anaemia, 47/148 (32.0%) moderate anaemia, and 7/148 (4.8%) with severe anaemia. The mean haemoglobin (hb) was lower among children with more advanced HIV disease (p<0.0001). Microcytic-hypochromic anaemia (44.9%) was the commonest type of anaemia. Anaemia was independently associated with young age (p <0.0001), advanced HIV WHO disease stage (p = 0.034) and low CD4 percentage (p = 0.048). The proportion of children who had attained viral suppression (viral load <400 copies/ml) at 3 months was significantly lower among the anaemic children, 31/58 (53.4%) compared to the non-anaemic children 26/30 (86.7%) (p=0.002). However, the difference in clinical and immunological response between the anaemic and non-anaemic patients did not reach statistical significance.Anaemia is highly prevalent among HIV-infected children in a rural Ugandan clinic and is associated with poorer virological suppression. However, the anaemia did not impact clinical and immunological response to ART among these children.Anaemia has been recognized as an important clinical problem in HIV-infected patients [1-3] with an estimated prevalence ranging from 10% in asymptomatic HIV-infected patients to 92% in patients with AIDS [4,5]. In Uganda, anaemia was shown to have a high prevalence of 92% and an overall cumulative incidence of 100% among young HIV-infected children at baseline in a hospital-based cohort [6].Studies done earlier found an association between the presence of anaemia at baseline and decreased survival as well as increased disease progression in patients with HIV inf