The prevalence and etiology of anemia among HIV-infected children in India
Autor: | Nirmala Rajagopalan, Anita Shet, Arun S. Shet, Karthika Arumugam, Chitra Dinakar, Saurabh Mehta, Shubha Krishnamurthy |
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Rok vydání: | 2011 |
Předmět: |
Male
medicine.medical_specialty Pediatrics Anemia Iron India HIV Infections Pilot Projects Gastroenterology Risk Factors Internal medicine Prevalence medicine Humans Prospective Studies Vitamin B12 Child Soluble transferrin receptor biology business.industry Iron deficiency medicine.disease Micronutrient Anti-Retroviral Agents Iron-deficiency anemia Child Preschool Dietary Supplements Pediatrics Perinatology and Child Health Linear Models biology.protein Female Hemoglobin Underweight medicine.symptom business |
Zdroj: | European Journal of Pediatrics. 171:531-540 |
ISSN: | 1432-1076 0340-6199 |
DOI: | 10.1007/s00431-011-1599-y |
Popis: | In this report, the prevalence and multifactorial etiology of anemia among Indian human immunodeficiency virus (HIV)-infected children are described. HIV-infected children aged 2–12 years were prospectively enrolled in 2007–2008. Measured parameters included serum ferritin, vitamin B12, red-cell folate, soluble transferrin receptor, and C-reactive protein. Children received antiretroviral therapy (ART), iron and, folate supplements as per standard of care. Among 80 enrolled HIV-infected children (mean age 6.8 years), the prevalence of anemia was 52.5%. Etiology of anemia was found to be iron deficiency alone in 38.1%, anemia of inflammation alone in 38.1%, combined iron deficiency and anemia of inflammation alone in 7.1%, vitamin B12 deficiency in 7.1%, and others in 9.5%. Median iron intake was 5.7 mg/day (recommended dietary allowance 18–26 mg/day). Compared to nonanemic children, anemic children were more likely to be underweight (weight Z-score −2.5 vs. -1.9), stunted (height Z-score −2.6 vs. -1.9), with lower CD4 counts (18% vs. 24%, p < 0.01), and higher log viral load (11.1 vs. 7.1, p < 0.01). Hemoglobin (Hb) improved significantly among those who started ART (baseline Hb 11.6 g/dl, 6-month Hb 12.2 g/dl, p = 0.03). Children taking ART combined with iron supplements experienced a larger increase in Hb compared to those receiving neither ART nor iron supplements (mean Hb change 1.5 g/dl, p < 0.01). Conclusion Anemia, particularly iron deficiency anemia and anemia of inflammation, is highly prevalent among children with HIV infection. Micronutrient supplements combined with ART improved anemia in HIV-infected children. |
Databáze: | OpenAIRE |
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