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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Risk factors and prognostic significance of platelet count abnormalities in children with HIV infection on antiretroviral therapy
AIDS, Volume 37, No. 3, Year 2023
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Description
Objectives:To establish the incidence, risk factors and correlation with survival of thrombocytopenia and thrombocytosis (T/T) among children with HIV infection (CWH).Design:A retrospective nested case control study of patients 0-18 years in five Baylor International Pediatric AIDS Initiative (BIPAI) centers in sub-Sahara Africa, 2004-2014.Methods:Clinical and laboratory variables including complete blood counts (CBC) were extracted from the BIPAI electronic medical record system. Incident cases of T/T were identified and frequency-matched on follow-up time with controls with normal platelets. We calculated the prevalence and incidence density of T/T and used conditional logistic regression to evaluate their association with selected clinical variables. We constructed Kaplan-Meier curves and a Cox proportional hazards model to evaluate the impact of T/T on survival.Results:Two thousand, one hundred and nine children were sampled. The incidence density of thrombocytopenia was 1 per 57.9 (95% confidence interval [CI] 50.3-66.8) CWH-years. Thrombocytopenia was higher in children with WHO Stage III/IV, lower in children on zidovudine, and had no association with use of lamivudine or nevirapine, CD4+ suppression, age, and nutrition status. Thrombocytopenia was independently associated with 2.2-fold higher mortality (95% CI 1.62-3.08). The incidence density of thrombocytosis was 1 per 11.4 (95% CI 10.7-12.1) CWH-years. Thrombocytosis was associated with higher CD4+ cell count, younger age, and use of lamivudine or nevirapine, and did not impact survival.Conclusions:Platelet count is a clinically valuable biomarker of HIV clinical progression and mortality. Laboratory studies are necessary to elucidate the mechanisms of T/T. © Copyright 2023 Wolters Kluwer Health, Inc. All rights reserved.
Authors & Co-Authors
Lubega, Joseph
United States, Houston
Baylor College of Medicine
Kim, Taylor Olmsted
United States, Houston
Baylor College of Medicine
Airewele, Gladstone E.
United States, Houston
Baylor College of Medicine
Grimes, Amanda Bell
United States, Houston
Baylor College of Medicine
Bulsara, Shaun
United States, Houston
Baylor College of Medicine
Peckham-Gregory, Erin C.
United States, Houston
Baylor College of Medicine
Wanless, Sebastian R.
United States, Houston
Baylor International Pediatric Aids Initiative
Haq, Heather
United States, Houston
Baylor College of Medicine
Elyanu, Peter J.
United States, Houston
Baylor International Pediatric Aids Initiative
Musoke, Philippa Martha
United States, Houston
Baylor International Pediatric Aids Initiative
Lumumba, Mwita
United States, Houston
Baylor International Pediatric Aids Initiative
Kekitiinwa, Adeodata R.
United States, Houston
Baylor International Pediatric Aids Initiative
Matshaba, Mogomotsi S.
United States, Houston
Baylor International Pediatric Aids Initiative
Scheurer, Michael E.
United States, Houston
Baylor College of Medicine
Despotovic, Jenny Mc Dade
United States, Houston
Baylor College of Medicine
Statistics
Authors: 15
Affiliations: 2
Identifiers
Doi:
10.1097/QAD.0000000000003387
ISSN:
02699370
Research Areas
Food Security
Health System And Policy
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Case-Control Study