Publication:
Incidence and predictors of severe anemia in Asian HIV-infected children using first-line antiretroviral therapy

Issued Date

2013-10-01

Resource Type

Short Survey

ISSN

18783511
12019712

DOI

10.1016/j.ijid.2013.04.006

Other identifier(s)

2-s2.0-84883783112

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

International Journal of Infectious Diseases. Vol.17, No.10 (2013)

Suggested Citation

Torsak Bunupuradah, Azar Kariminia, Kwai Cheng Chan, Reshmie Ramautarsing, Bui Vu Huy, Ning Han, Revathy Nallusamy, Rawiwan Hansudewechakul, Vonthanak Saphonn, Virat Sirisanthana, Kulkanya Chokephaibulkit, Nia Kurniati, Nagalingeswaran Kumarasamy, Nik Khairulddin Nik Yusoff, Kamarul Razali, Siew Moy Fong, Annette H. Sohn, Pagakrong Lumbiganon Incidence and predictors of severe anemia in Asian HIV-infected children using first-line antiretroviral therapy. International Journal of Infectious Diseases. Vol.17, No.10 (2013). doi:10.1016/j.ijid.2013.04.006 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/32150

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Title

Incidence and predictors of severe anemia in Asian HIV-infected children using first-line antiretroviral therapy

Author(s)

Torsak Bunupuradah
 Azar Kariminia
 Kwai Cheng Chan
 Reshmie Ramautarsing
 Bui Vu Huy
 Ning Han
 Revathy Nallusamy
 Rawiwan Hansudewechakul
 Vonthanak Saphonn
 Virat Sirisanthana
 Kulkanya Chokephaibulkit
 Nia Kurniati
 Nagalingeswaran Kumarasamy
 Nik Khairulddin Nik Yusoff
 Kamarul Razali
 Siew Moy Fong
 Annette H. Sohn
 Pagakrong Lumbiganon

Other Contributor(s)

The HIV Netherlands Australia Thailand Research Collaboration
 University of New South Wales (UNSW) Australia
 Hospital Pulau Pinang
 Academic Medical Centre, University of Amsterdam
 National Hospital of Pediatrics Hanoi
 Beijing Ditan Hospital
 Chiangrai Prachanukroh Hospital
 National Pediatric Hospital
 Chiang Mai University
 Mahidol University
 University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
 YR Gaitonde Centre for AIDS Research and Education
 Hospital Raja Perempuan Zainab II
 Kuala Lumpur Hospital
 Hospital Likas
 TREAT Asia/amfAR-The Foundation for AIDS Research
 Khon Kaen University

Abstract

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) log10copies/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. © 2013 International Society for Infectious Diseases.

Keyword(s)

Medicine

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https://repository.li.mahidol.ac.th/handle/20.500.14594/32150

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