Characteristics of Anemia in Children with HIV Infection

Mohammad Ghozali, Al Farizi Adhi Sunjaya, Agnes Rengga Indrati

Abstract


Anemia is a hematologic complication commonly encountered in HIV patients. Although the severity of anemia is generally mild, anemia has been shown to be a strong risk factor for disease progression, particularly in HIV infected person. With different severity and types of anemia in HIV patients, it is necessary to identify the severity and type of anemia in HIV-infected children, thus helping to determine the prognosis and management of their anemia. The purpose of this study was to describe HIV patient staging infection, co-morbidities, and type of anemia in HIV-infected children based on their therapy. A descriptive quantitative research was conducted in Dr. Hasan Sadikin General Hospital Bandung. Data were collected from patients’ medical records diagnosed with HIV between 2015–2017. The severity of anemia was set according to World Health Organization standards in 2011 and the types of anemia were identified from the erythrocyte index on routine hematologic examination. Forty-seven of 73 children had anemia. Based on the severity of anemia, 26% mild anemia, 60% moderate anemia, and 15% severe anemia were found. Subsequently, hypochromic microcytic (40%), macrocytic (32%), and normocytic normochromic (28%) anemia were identified. Considering the direct and indirect mechanism to yield anemia in HIV-infected patients, this double sword symptom becomes the most common complication burdened the growth and development of HIV-infected children. This study made it even more pronounced.

Key words: Anemia, Children, HIV

 

Karakteristik Anemia pada Anak Terinfeksi HIV

Anemia adalah komplikasi hematologi paling sering ditemukan pada pasien HIV. Meskipun tingkat anemia pada umumnya ringan, anemia telah terbukti menjadi faktor risiko kuat terhadap perkembangan penyakit. Terdapat perbedaan tipe anemia pada pasien HIV dengan etiologi yang berbeda pula sehingga perlu dilakukan identifikasi mengenai tingkat dan tipe anemia pada pasien HIV anak, yang pada akhirnya dapat membantu menentukan prognosis dan penatalaksanaan anemia pada pasien ini. Suatu penelitian deskriptif kuantitatif ini bertujuan mengetahuitingkat dan tipe anemia dengan mengklasifikasikannya berdasarkan komorbiditas pada pasien HIV/AIDS anak di RSHS tahun 2015–2017 menggunakan data rekam medik pasien pemeriksaan hematologi rutin. Tingkat anemia ditetapkan berdasar atas standar WHO, sementara jenis anemia dilihat dari indeks eritrosit. Sebanyak 73 pasien anak terinfeksi HIV, didapatkan 47 anak mengalami anemia. Tingkat anemia ditemukan anemia ringan (26%), anemia sedang (60%), dan anemia berat (15%). Tipe anemia yang ditemukan adalah normositik normokromik (28%), makrositik (32%), dan mikrositik hipokromik (40%). Tingkat anemia pada pasien HIV anak di RSHS pada umumnya adalah anemia sedang. Tipe anemia terbanyak pada penelitian adalah mikrositik hipokromik.

 Kata kunci: Anak, anemia, HIV


Keywords


Anemia; Children; HIV;

Full Text:

PDF

References


Redig AJ, Berliner N. Pathogenesis and clinical implications of HIV-related anemia in 2013. American Society of Hematology. 2013;2013(1):377–81.

Sumantri R, Supandiman I, Idjradinata P, Ven Avd, Crevel Rv. Death opportunities for human immunodeficiency virus-acquired immune deficiency syndrome based on combined degree of anemia, body mass index, and number of cluster differentiation MKB. 2012;44(1):50–6.

Kemenkes. Health data and information, Indonesia Health Profile 2016. In: RI KK, editor. Jakarta: Kementrian Kesehatan Republik Indonesia; 2017.

Greer JP, Arber DA, Glader B, List AF, Robert T, Means J, et al. Wintrobe’s Clinical hematology. 13th ed: Philadelphia: Wolters Kluwer Health; 2014.

Wisaksana R, Sumantri R, Indrati AR, Zwitser A, Jusuf H, Mast Qd, et al. Anemia and iron homeostasis in a cohort of HIV-infected patients in Indonesia. BMC Infect Dis. 2011;11(1):1.

Meidani M, Rezaei F, Maracy MR, Avijgan M, Tayeri K. Prevalence, severity, and related factors of anemia in HIV/AIDS patients. J Res Med Sci. 2012;17(2):138–42.

Takuva S, Maskew M, Brennan AT, Sanne I, MacPhail AP, Fox MP. Anemia among HIV-infected patients initiating antiretroviral therapy in South Africa: improvement in hemoglobin regardless of degree of immunosuppression and the initiating ART regimen. J Trop Med. 2013;2013:1–6.

Enawgaw B, Alem M, Melku M, Addis Z, Terefe B, Yitayew G. Prevalence and associated risk factors of anemia among HIV infected children attending Gondar university hospital, Northwest Ethiopia: a cross sectional study. BMC Hematol. 2015; 15(12):1-6.

WHO. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Geneva: World Health Organization; 2011.

Johannessen A, Naman E, Gundersen SG, Bruun JN. Antiretroviral treatment reverses HIV-associated anemia in rural Tanzania. BMC Infect Dis. 2011;11(1):1–9.

Gedefaw L, Yemane T, Sahlemariam Z, Yilma D. Anemia and Risk Factors in HAART Naïve and HAART Experienced HIV Positive Persons in South West Ethiopia: A Comparative Study. PLoS ONE. 2013;8(8):1–5.

Shet A, Arumugam K, Rajagopalan N, Dinakar C, Krishnamurthy S, Mehta S, et al. The prevalence and etiology of anemia among HIV-infected children in India. Eur J Pediatr. 2012;171(3):531–40.

Yaranal PJ, Umashankar T, Govindareddy S, Harish. Hematological Profile in Pulmonary Tuberculosis. Int J Health Rehab Sci. 2013; 2(1):50–5.

Nigam JS, Bharti JN, Kumar D, Sharma A. A comparison of hemoglobin A2 levels in untreated and treated groups of HIV Patients on ART including zidovudine. Patholog Research International. 2013;2013:1–3.

Koury MJ. Abnormal erythropoiesis and the pathophysiology of chronic anemia. Blood reviews. 2014;28(2):49–66.

Ndeezi G, Tumwine JK, Ndugwa CM, Bolann BJ, Tylleskär T. Multiple micronutrient supplementation improves vitamin B12 and folate concentrations of HIV infected children in Uganda: a randomized controlled trial. Nutr J. 2011;10(56):1–9.

Shaw JG, Friedman JF. Iron deficiency anemia: focus on infectious diseases in lesser developed countries. Anemia. 2011;2011:1–10.




DOI: http://dx.doi.org/10.15395/mkb.v50n2.1236

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.



 

This Journal indexed by

           


Creative Commons License
MKB is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

 


View My Stats