Prevalence and correlates of cytopenias in HIV-infected adults initiating highly active antiretroviral therapy in Uganda.
Prevalence and correlates of cytopenias in HIV-infected adults initiating highly active antiretroviral therapy in Uganda.
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在乌干达启动高度活跃的抗逆转录病毒疗法的HIV感染成年人中细胞质的患病率和相关性。
DOI：
10.1186/1471-2334-14-496
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发表时间：
2014-09-10
影响因子：
3.7
通讯作者：
Guwatudde D
中科院分区：
文献类型：
--
作者：
Kyeyune R;Saathoff E;Ezeamama AE;Löscher T;Fawzi W;Guwatudde D
血细胞减少是最常见的HIV相关血液学异常。血细胞减少症与多种因素相关，包括性别、种族/民族、地理位置和合并症，如结核病、B型肝炎感染、发热和口腔念珠菌病。随着艾滋病毒的进展，细胞减少症变得更加普遍，并且往往是致命的。来自资源有限环境的有关血细胞减少症患病率和相关因素的数据有限。因此，我们进行了这项横断面研究，以评估乌干达成人艾滋病患者在开始HAART时血细胞减少的患病率和相关性。400例HAART初治或接受HAART ≤ 6个月的HIV感染受试者入组多效唑、HAART和HIV/AIDS试验。根据WHO指南，贫血定义为任何血红蛋白浓度< 12 g/dl（非妊娠女性）和< 13 g/dl（男性）。使用研究中心实验室参考范围定义白细胞减少症和血小板减少症，因为这两种细胞系缺乏普遍接受的定义，即白细胞减少症（如果女性白色血细胞计数< 2.75 × 109个细胞/升）和血小板减少症（如果女性血小板< 125 × 109个细胞/升和男性血小板< 156 × 109个细胞/升）。进行单变量和双变量分析以描述患者人群，并使用对数二项式回归来量化血细胞减少的相关性。400名受试者中有65%至少有一种形式的血细胞减少症。贫血发生率为47.8%，白细胞减少发生率为24.3%，血小板减少发生率为8.3%，双细胞减少发生率为21.9%，仅2例发生全血细胞减少。血细胞减少症在女性中更常见（患病率[PR]：1.33，95%置信区间[CI]：1.12-1.59）; CD 4计数分类50至<200（PR：0.75，95% CI：0.64 - 0.88）和CD 4计数分类200至<350（PR：0.74，95%CI：0.59 - 0.92）与CD 4计数类别<50相比;正常BMI（PR：0.82，95%CI：0.68-1.00）和超重BMI（PR：0.64，95%CI：0.50- 0.82）与体重不足BMI和具有口腔念珠菌病病史或存在口腔念珠菌病的那些相比。血细胞减少症是乌干达艾滋病毒感染成人在开始HAART时常见的并发症。任何血细胞减少症的存在与女性、CD 4计数降低和体重指数降低相关。需要在资源有限的情况下对艾滋病毒相关血细胞减少的趋势进行前瞻性研究。
Cytopenias are the most common HIV-associated hematological abnormality. Cytopenias have been associated with several factors including sex, race/ethnicity, geographical location and comorbidities such as tuberculosis, hepatitis B infection, fever and oral candidiasis. Cytopenias become more prevalent as HIV progresses and are often fatal. Data from resource-limited settings about the prevalence and correlates of cytopenia are limited. Therefore we conducted this cross-sectional study to assess the prevalence and correlates of cytopenia among adult AIDS patients at initiation of HAART in Uganda. 400 HIV-infected subjects who were HAART-naïve or on HAART for ≤ 6 months were enrolled into the Multivitamins, HAART and HIV/AIDS Trial. Anemia was defined according to WHO guidelines as any hemoglobin concentration < 12 g/dl for non-pregnant females and < 13 g/dl for males. Leucopenia and thrombocytopenia were defined using study site laboratory reference ranges for lack of generally accepted definitions for these 2 cell lines as leucopenia if white blood cell count < 2.75 × 109 cells/litre and thrombocytopenia if platelets < 125 × 109 cells/litre for females and < 156 × 109 cells/litre for males. Univariate and bivariate analyses were done to describe the patient population and log-binomial regression was used to quantify the correlates of cytopenia. Sixty five percent of the 400 subjects had at least one form of cytopenia. Anemia occurred in 47.8%, leucopenia in 24.3%, thrombocytopenia in 8.3%, bicytopenia in 21.9% and only 2 had a pancytopenia. Cytopenia was more prevalent in females (prevalence ratio [PR]:1.33, 95% confidence interval [CI]:1.12-1.59); CD4 count category 50 to <200 (PR: 0.75, 95% CI: 0.64 -0.88) and CD4 count category 200 to <350 (PR: 0.74, 95% CI: 0.59 - 0.92) compared to CD4 count category <50; normal BMI (PR: 0.82, 95% CI:0.68-1.00) and overweight BMI (PR: 0.64, 95% CI:0.50- 0.82) compared to underweight BMI and those with a history or presence of oral candidiasis. Cytopenias are a frequent complication in HIV-infected adults at initiation of HAART in Uganda. The presence of any cytopenia was associated with female sex, decreasing CD4 count and decreasing body mass index. Prospective studies in resource-limited settings on the trend in HIV-related cytopenias are needed.
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DOI：
10.1016/s0140-6736(08)61113-7
发表时间：
2008-07-26
期刊：
Lancet (London, England)
影响因子：
--
作者：
Antiretroviral Therapy Cohort Collaboration
通讯作者：
Antiretroviral Therapy Cohort Collaboration
影响因子：
8.4
作者：
Firnhaber, Cynthia;Smeaton, Laura;Saukila, Nasinuku;Flanigan, Timothy;Gangakhedkar, Raman;Kumwenda, Johnstone;La Rosa, Alberto;Kumarasamy, Nagalingeswaran;De Gruttola, Victor;Hakim, James Gita;Campbell, Thomas B.
通讯作者：
Campbell, Thomas B.
影响因子：
1
作者：
Koka, PS;Reddy, ST
通讯作者：
Reddy, ST
影响因子：
2.9
作者：
MCGINNISS, MH;MACHER, AM;ALTER, HJ
通讯作者：
ALTER, HJ
影响因子：
20.3
作者：
Jenkins, M;Hanley, MB;McCune, JM
通讯作者：
McCune, JM