Assessment of haematological parameters in HIV-infected and uninfected Rwandan women: a cross-sectional study

作者：Munyazesa Elisaphane^*; Emile Ivan; Mutimura Eugene; Hoover Donald R; Shi Qiuhu; McGinn Aileen P; Musiime Stephenson; Muhairwe Fred; Rutagengwa Alfred; Dusingize Jean Claude; Anastos Kathryn

来源：BMJ Open, 2012, 2(6): e001600.

DOI：10.1136/bmjopen-2012-001600

Objectives: Although haematological abnormalities are common manifestations of HIV infection, few studies on haematological parameters in HIV-infected persons have been undertaken in sub-Saharan Africa. The authors assessed factors associated with haematological parameters in HIV-infected antiretroviral-naive and HIV-uninfected Rwandan women. %26lt;br%26gt;Study design: Cross-sectional analysis of a longitudinal cohort. %26lt;br%26gt;Setting: Community-based women%26apos;s associations. %26lt;br%26gt;Participants: 710 HIV-infected (HIV+) antiretroviral-nave and 226 HIV-uninfected (HIV-) women from the Rwanda Women%26apos;s Interassociation Study Assessment. Haematological parameters categorised as (abnormal vs normal) were compared by HIV status and among HIV+ women by CD4 count category using proportions. Multivariate logistic regression models using forward selection were fit. %26lt;br%26gt;Results: Prevalence of anaemia (haemoglobin (Hb) %26lt;12.0 g/dl) was higher in the HIV+ group (20.5% vs 6.3%; p%26lt;0.001), and increased with lower CD4 counts: %26gt;= 350 (7.6%), 200-349 (16%) and %26lt;200 cells/mm(3) (32.2%). Marked anaemia (Hb %26lt;10.0 g/dl) was found in 4.2% of HIV+ and none of the HIV-women (p%26lt;0.001), and was highest in HIV+ women with CD4 %26lt;200 cells/mm(3) (8.4%). The HIV+ were more likely than HIV-women (4.2 vs 0.5%, respectively, p=0.002) to have moderate neutropenia with white blood cells %26lt;2.0x10(3) cells/mm(3) and 8.4% of HIV+ women with CD4 %26lt;200 cells/mm(3) had moderate neutropenia. In multivariate logistic regression analysis, BMI (OR 0.87/kg/m(2), 95% CI 0.82 to 0.93; p%26lt;0.001), CD4 200-350 vs HIV-(OR 3.59, 95% CI 1.89 to 6.83; p%26lt;0.001) and CD4 %26lt;200 cells/mm(3) vs HIV-(OR 8.09, 95% CI 4.37 to 14.97; %26lt;0.001) had large independent associations with anaemia. There were large independent associations of CD4 %26lt;200 cells/mm(3) vs HIV-(OR 7.18, 95% CI 0.78 to 65.82; p=0.081) and co-trimoxazole and/or dapsone use (OR 5.69, 95% CI 0.63 to 51.45; p=0.122) with moderate neutropenia. %26lt;br%26gt;Conclusions: Anaemia was more common than neutropenia or thrombocytopenia in the HIV-infected Rwandan women. Future comparisons of haematological parameters in HIV-infected patients before and after antiretroviral therapy initiation are warranted.

• 出版日期2012