Magnitude and Factors Associated with Cytopenia Among Children on Highly Active Antiretroviral Therapy at Hawassa University College of Medicine and Health Science, Sidama Region, Southern Ethiopia

Abstract

Background: The most common abnormality in HIV-infected children is cytopenia, a hematological complication characterized by a decline in any of the blood cell lines. It is associated with a higher risk of morbidity and mortality. Therefore, this study aimed to assess the prevalence and associated factors of cytopenia among HIV-positive children on highly active antiretroviral therapy (HAART). Methods: Hospital-based cross-sectional study design was conducted on HIV-positive children on HAART from July to September 2020. Socio-demographic and clinical characteristics of the study participants’ data were collected using a structured questionnaire. Hematological parameters from the blood sample were analyzed using Ruby Cell-Dyne 300 hematology auto-analyzer. The data were analyzed using SPSS version 20. Logistic regression was used to assess the predictors of cytopenia among the study participants. P-values of less than 0.05 are considered statistically significant. Results: Two hundred seventy-three HAART-experienced children were enrolled in this study, and 50.9% were females. At baseline, 40.7% of children were anemic. The overall magnitude of cytopenia among the study participants was 26.7%. The prevalence of anemia, thrombocytopenia, leucopenia and neutropenia among children was 11.4%, 4.0%, 14.3%, and 18.3%, respectively. Patients with an undetectable viral load (AOR = 0.5, CI = 0.3–0.9) are 50% less likely to report cytopenia. HAART-experienced children living in rural areas are more likely to develop cytopenia (AOR = 2.6, CI = 1.3–5.2) than those living in urban areas. Conclusion: Hematologic abnormalities are common problems among children on highly active antiretroviral therapy. Therefore, routine investigation of hematological and immunological changes following appropriate therapeutic interventions is recommended.