TY - JOUR
T1 - Incidence and predictors of severe anemia in Asian HIV-infected children using first-line antiretroviral therapy
AU - Bunupuradah, Torsak
AU - Kariminia, Azar
AU - Chan, Kwai Cheng
AU - Ramautarsing, Reshmie
AU - Huy, Bui Vu
AU - Han, Ning
AU - Nallusamy, Revathy
AU - Hansudewechakul, Rawiwan
AU - Saphonn, Vonthanak
AU - Sirisanthana, Virat
AU - Chokephaibulkit, Kulkanya
AU - Kurniati, Nia
AU - Kumarasamy, Nagalingeswaran
AU - Yusoff, Nik Khairulddin Nik
AU - Razali, Kamarul
AU - Fong, Siew Moy
AU - Sohn, Annette H.
AU - Lumbiganon, Pagakrong
N1 - Funding Information:
The TREAT Asia Pediatric HIV Observational Database is an initiative of TREAT Asia, a program of amfAR, The Foundation for AIDS Research, with support from the US National Institutes of Health's National Institute of Allergy and Infectious Diseases, Eunice Kennedy Shriver National Institute of Child Health and Human Development, and National Cancer Institute as part of the International Epidemiologic Databases to Evaluate AIDS (IeDEA; U01AI069907), and the AIDS Life Association. The Kirby Institute is funded by the Australian Government Department of Health and Ageing, and is affiliated with the Faculty of Medicine, The University of New South Wales. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any of the institutions mentioned above. The authors wish to thank the children and the staff at the participating centers who have given their time so generously during the course of this project, and Dr Gonzague Jourdain for his critical review of the manuscript.
PY - 2013/10
Y1 - 2013/10
N2 - Background: There are limited data on treatment-related anemia in Asian HIV-infected children. Methods: Data from Asian HIV-infected children aged <18 years on first-line highly active antiretroviral therapy (HAART) were used. Children who had pre-existing severe anemia at baseline were excluded. Anemia was graded using the United States Division of AIDS (DAIDS) 2004 table. Potential risk factors for severe anemia were assessed by logistic regression. Results: Data from 1648 children (51.9% female, 62.8% World Health Organization (WHO) stage 3/4) were analyzed. Median (interquartile range) age was 6.8 (3.7-9.6) years, CD4% was 9 (3-16)%, and plasma HIV-RNA was 5.2 (4.7-5.6) log10 copies/ml at HAART initiation in those with available testing. The most common regimens were stavudine/lamivudine/nevirapine (42%) and zidovudine/lamivudine/nevirapine (25%). Severe anemia was identified in 47 (2.9%) children after a median time of 6 months after HAART initiation, with an incidence rate of 5.4 per 100 child-years. Mild anemia or moderate anemia at baseline (p = 0.024 and p = 0.005, respectively), previous or current use of zidovudine (p < 0.0001 and p = 0.013, respectively), and male sex (p = 0.008) were associated with severe anemia. Higher weight-for-age z-score (p = 0.004) was protective. Conclusions: The incidence of severe anemia in Asian HIV-infected children after HAART initiation was low and mainly occurred during the first few months after HAART initiation. Mild to moderate anemia at baseline and using zidovudine were independent risk factors for the development of severe anemia.
AB - Background: There are limited data on treatment-related anemia in Asian HIV-infected children. Methods: Data from Asian HIV-infected children aged <18 years on first-line highly active antiretroviral therapy (HAART) were used. Children who had pre-existing severe anemia at baseline were excluded. Anemia was graded using the United States Division of AIDS (DAIDS) 2004 table. Potential risk factors for severe anemia were assessed by logistic regression. Results: Data from 1648 children (51.9% female, 62.8% World Health Organization (WHO) stage 3/4) were analyzed. Median (interquartile range) age was 6.8 (3.7-9.6) years, CD4% was 9 (3-16)%, and plasma HIV-RNA was 5.2 (4.7-5.6) log10 copies/ml at HAART initiation in those with available testing. The most common regimens were stavudine/lamivudine/nevirapine (42%) and zidovudine/lamivudine/nevirapine (25%). Severe anemia was identified in 47 (2.9%) children after a median time of 6 months after HAART initiation, with an incidence rate of 5.4 per 100 child-years. Mild anemia or moderate anemia at baseline (p = 0.024 and p = 0.005, respectively), previous or current use of zidovudine (p < 0.0001 and p = 0.013, respectively), and male sex (p = 0.008) were associated with severe anemia. Higher weight-for-age z-score (p = 0.004) was protective. Conclusions: The incidence of severe anemia in Asian HIV-infected children after HAART initiation was low and mainly occurred during the first few months after HAART initiation. Mild to moderate anemia at baseline and using zidovudine were independent risk factors for the development of severe anemia.
KW - Anemia
KW - Antiretroviral therapy
KW - Asia
KW - Pediatric HIV
UR - http://www.scopus.com/inward/record.url?scp=84883783112&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2013.04.006
DO - 10.1016/j.ijid.2013.04.006
M3 - Short survey
C2 - 23764352
AN - SCOPUS:84883783112
SN - 1201-9712
VL - 17
SP - e806-e810
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
IS - 10
ER -
