Browsing by Author "Saathoff, Elmar"

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    Hematological Profiles of HIV-infected Adults Initiating Highly Active Antiretroviral Therapy (HAART) in Uganda
    (AIDS Research and Human Retroviruses, 2014) Kyeyune, Rachel; Saathoff, Elmar; Ezeamama, Amara; Fawzi, Wafaie; Loescher, Thomas; Guwatudde, David
    Cytopenias are the most common HIV-associated hematological abnormality. Cytopenias become more prevalent as HIV progresses and are often fatal. Sex, race, geographical location and comorbidities such as tuberculosis have been associated with cytopenias. Data from resource-limited settings about the prevalence, correlates and trends in cytopenia are limited. This analysis assessed the prevalence and correlates of cytopenia at initiation of HAART and the trend in cytopenias among HAART-treated AIDS patients in Uganda.
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    Prevalence and correlates of cytopenias in HIV-infected adults initiating highly active antiretroviral therapy in Uganda
    (BMC Infectious Diseases, 2014) Kyeyune, Rachel; Saathoff, Elmar; Ezeamama, Amara E.; Löscher, Thomas; Fawzi, Wafaie; Guwatudde, David
    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. Methods: 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. Results: 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. Conclusions: 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.