|dc.description.abstract||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.||en_US