Anti-retroviral Treatment Related Haematological Disorders among HIV- Infected Children Attending HIV Clinic at Yekatit 12 Hospital, Addis Ababa, Ethiopia

Abstract

Background: The Management of drug toxicities is increasingly becoming a crucial component of human immunodeficiency virus infection and improvement of antiretroviral therapy in developing countries like Ethiopia. The severity of hematological abnormalities in children who are taking ART is not known well in Ethiopian Hospitals. Objective: The study was undertaken to determine the severity of HAART related hematological disorders in HIV positive children who were on HAART at Yekatit 12 Hospital, Addis Ababa, Ethiopia. Methods: A cross sectional study was conducted from May 2012 to February 2013 among children who had been on HAART for maximum of twelve months. Data collection using questionnaires and measurement of complete blood count and CD4 + T cell counts were made by using standard methodology. The results were tested using appropriate statistical methods (mean, Standard Deviation, Odd Ratio, p-value and F test value). Results: A total of 106 patients (<18 years) were enrolled  in the study and had a mean age of 6.5±3.4 years, a median age of 7 years and female to male ratio of 1.04:1. The prevalence of anemia was 18.9%, 12.3% and 10.4% at baseline, at six months, and at twelve months post-treatment, respectively. Their mean hemoglobin level increased by 1.0 gm/dl at six months and by 1.7 gm/dl at twelve months of follow up with statistically significant values (p <0.001), and F test value presented 15.87. Patients who were put on AZT based regimen were more likely to develop anemia than those on D4T-based regimen, (OR=4.5, p-value <0.05). The prevalence of thrombocytopenia at baseline was 8.5%, but it was lowered for both at six and twelve months by 5.7%. The thrombocyte count of AZT based regimen showed statistically significant association (p- <0.05) and F test value as 2.98. The prevalence of neutropenia at baseline and at six months was similar with the value of 2.8% while at twelve months it was higher at 5.7%. Conclusion: Anemia, neutropenia and thrombocytopenia were the hematological abnormalities among HIV infected Ethiopian children taking HAART. Anemia was the most common abnormality, but significantly lesser than in many other hospitals in Ethiopia and among those who were on AZT based regimen. It is recommended that even in limited laboratory monitoring, HAART can be safely used and health professionals may consider other risk factors associated with the development of cytopenia before selection of second line of HAART drug regimen.