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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Comparisons of anemia, thrombocytopenia, and neutropenia at initiation of HIV antiretroviral therapy in Africa, Asia, and the Americas
International Journal of Infectious Diseases, Volume 14, No. 12, Year 2010
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Description
Background: Hematological abnormalities are common manifestations of advanced HIV-1 infection that could affect the outcomes of highly-active antiretroviral therapy (HAART). Although most HIV-1-infected individuals live in resource-constrained countries, there is little information about the frequency of hematological abnormalities such as anemia, neutropenia, and thrombocytopenia among individuals with advanced HIV-1 disease. Methods: This study compared the prevalence of pre-antiretroviral therapy hematological abnormalities among 1571 participants in a randomized trial of antiretroviral efficacy in Africa, Asia, South America, the Caribbean, and the USA. Potential covariates for anemia, neutropenia, and thrombocytopenia were identified in univariate analyses and evaluated in separate multivariable models for each hematological condition. Results: The frequencies of neutropenia (absolute neutrophil count ≤1.3×109/l), anemia (hemoglobin ≤10g/dl), and thrombocytopenia (platelets ≤125×109/l) at initiation of antiretroviral therapy were 14%, 12%, and 7%, respectively, and varied by country (p<0.0001 for each). In multivariable models, anemia was associated with gender, platelet count, and country; neutropenia was associated with CD4+ lymphocyte and platelet counts; and thrombocytopenia was associated with country, gender, and chronic hepatitis B infection. Conclusions: Differences in the frequency of pretreatment hematological abnormalities could have important implications for the choice of antiretroviral regimen in resource-constrained settings. © 2010 International Society for Infectious Diseases.
Authors & Co-Authors
Firnhaber, Cynthia S.
South Africa, Johannesburg
University of the Witwatersrand
Smeaton, Laura M.
United States, Boston
Harvard T.h. Chan School of Public Health
Saukila, Nasinuku
Malawi, Lilongwe
Kamuzu Central Hospital
Flanigan, Timothy Palen
United States, Providence
The Warren Alpert Medical School
Gangakhedkar, Raman Raghunathrao
India, Pune
National Aids Research Institute India
Kumwenda, Johnstone J.
Malawi, Zomba
University of Malawi
la Rosa, Alberto M.
Peru, Lima
Asociación Civil Impacta Salud y Educación
Kumarasamy, Nagalingeswaran
India, Chennai
Research Foundation
Gruttola, Victor De
India, Chennai
Research Foundation
Hakim, James Gita
Zimbabwe, Harare
University of Zimbabwe
Campbell, Thomas B.
United States, Aurora
University of Colorado Anschutz Medical Campus
Statistics
Citations: 72
Authors: 11
Affiliations: 10
Identifiers
Doi:
10.1016/j.ijid.2010.08.002
ISSN:
12019712
Research Areas
Infectious Diseases
Study Design
Cross Sectional Study