Assessment of haematological parameters in HIV-infected and uninfected Rwandan women: A cross-sectional study

Elisaphane Munyazesa, Ivan Emile, Eugene Mutimura, Donald R. Hoover, Qiuhu Shi, Aileen P. McGinn, Stephenson Musiime, Fred Muhairwe, Alfred Rutagengwa, Jean Claude Dusingize, Kathryn Anastos

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Abstract

Objectives: Although haematological abnormalities are common manifestations of HIV infection, few studies on haematological parameters in HIV-infected persons have been undertaken in sub-Saharan Africa. The authors assessed factors associated with haematological parameters in HIV-infected antiretroviral- naïve and HIV-uninfected Rwandan women. Study design: Cross-sectional analysis of a longitudinal cohort. Setting: Community-based women's associations. Participants: 710 HIV-infected (HIV+) antiretroviral-naïve and 226 HIV-uninfected (HIV-) women from the Rwanda Women's Interassociation Study Assessment. Haematological parameters categorised as (abnormal vs normal) were compared by HIV status and among HIV+ women by CD4 count category using proportions. Multivariate logistic regression models using forward selection were fit. Results: Prevalence of anaemia (haemoglobin (Hb) <12.0 g/dl) was higher in the HIV+ group (20.5% vs 6.3%; p<0.001), and increased with lower CD4 counts: ≥350 (7.6%), 200-349 (16%) and <200 cells/mm3 (32.2%). Marked anaemia (Hb <10.0 g/dl) was found in 4.2% of HIV+ and none of the HIV- women (p<0.001), and was highest in HIV+ women with CD4 <200 cells/mm3 (8.4%). The HIV+ were more likely than HIV- women (4.2 vs 0.5%, respectively, p=0.002) to have moderate neutropenia with white blood cells < 2.0×103 cells/mm3 and 8.4% of HIV+ women with CD4 <200 cells/mm3 had moderate neutropenia. In multivariate logistic regression analysis, BMI (OR 0.87/kg/m2, 95% CI 0.82 to 0.93; p<0.001), CD4 200-350 vs HIV- (OR 3.59, 95% CI 1.89 to 6.83; p<0.001) and CD4 <200 cells/mm3 vs HIV- (OR 8.09, 95% CI 4.37 to 14.97; <0.001) had large independent associations with anaemia. There were large independent associations of CD4 <200 cells/mm3 vs HIV- (OR 7.18, 95% CI 0.78 to 65.82; p=0.081) and co-trimoxazole and/or dapsone use (OR 5.69, 95% CI 0.63 to 51.45; p=0.122) with moderate neutropenia. Conclusions: Anaemia was more common than neutropenia or thrombocytopenia in the HIV-infected Rwandan women. Future comparisons of haematological parameters in HIV-infected patients before and after antiretroviral therapy initiation are warranted.

Original languageEnglish (US)
Article numbere001600
JournalBMJ Open
Volume2
Issue number6
DOIs
StatePublished - 2012

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Cross-Sectional Studies
HIV
Neutropenia
Anemia
Logistic Models
CD4 Lymphocyte Count
Hemoglobins
Rwanda
Dapsone
Africa South of the Sahara
Sulfamethoxazole Drug Combination Trimethoprim
Thrombocytopenia
HIV Infections

ASJC Scopus subject areas

  • Medicine(all)

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Assessment of haematological parameters in HIV-infected and uninfected Rwandan women : A cross-sectional study. / Munyazesa, Elisaphane; Emile, Ivan; Mutimura, Eugene; Hoover, Donald R.; Shi, Qiuhu; McGinn, Aileen P.; Musiime, Stephenson; Muhairwe, Fred; Rutagengwa, Alfred; Dusingize, Jean Claude; Anastos, Kathryn.

In: BMJ Open, Vol. 2, No. 6, e001600, 2012.

Research output: Contribution to journalArticle

Munyazesa, E, Emile, I, Mutimura, E, Hoover, DR, Shi, Q, McGinn, AP, Musiime, S, Muhairwe, F, Rutagengwa, A, Dusingize, JC & Anastos, K 2012, 'Assessment of haematological parameters in HIV-infected and uninfected Rwandan women: A cross-sectional study', BMJ Open, vol. 2, no. 6, e001600. https://doi.org/10.1136/bmjopen-2012-001600
Munyazesa, Elisaphane ; Emile, Ivan ; Mutimura, Eugene ; Hoover, Donald R. ; Shi, Qiuhu ; McGinn, Aileen P. ; Musiime, Stephenson ; Muhairwe, Fred ; Rutagengwa, Alfred ; Dusingize, Jean Claude ; Anastos, Kathryn. / Assessment of haematological parameters in HIV-infected and uninfected Rwandan women : A cross-sectional study. In: BMJ Open. 2012 ; Vol. 2, No. 6.
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title = "Assessment of haematological parameters in HIV-infected and uninfected Rwandan women: A cross-sectional study",
abstract = "Objectives: Although haematological abnormalities are common manifestations of HIV infection, few studies on haematological parameters in HIV-infected persons have been undertaken in sub-Saharan Africa. The authors assessed factors associated with haematological parameters in HIV-infected antiretroviral- na{\"i}ve and HIV-uninfected Rwandan women. Study design: Cross-sectional analysis of a longitudinal cohort. Setting: Community-based women's associations. Participants: 710 HIV-infected (HIV+) antiretroviral-na{\"i}ve and 226 HIV-uninfected (HIV-) women from the Rwanda Women's Interassociation Study Assessment. Haematological parameters categorised as (abnormal vs normal) were compared by HIV status and among HIV+ women by CD4 count category using proportions. Multivariate logistic regression models using forward selection were fit. Results: Prevalence of anaemia (haemoglobin (Hb) <12.0 g/dl) was higher in the HIV+ group (20.5{\%} vs 6.3{\%}; p<0.001), and increased with lower CD4 counts: ≥350 (7.6{\%}), 200-349 (16{\%}) and <200 cells/mm3 (32.2{\%}). Marked anaemia (Hb <10.0 g/dl) was found in 4.2{\%} of HIV+ and none of the HIV- women (p<0.001), and was highest in HIV+ women with CD4 <200 cells/mm3 (8.4{\%}). The HIV+ were more likely than HIV- women (4.2 vs 0.5{\%}, respectively, p=0.002) to have moderate neutropenia with white blood cells < 2.0×103 cells/mm3 and 8.4{\%} of HIV+ women with CD4 <200 cells/mm3 had moderate neutropenia. In multivariate logistic regression analysis, BMI (OR 0.87/kg/m2, 95{\%} CI 0.82 to 0.93; p<0.001), CD4 200-350 vs HIV- (OR 3.59, 95{\%} CI 1.89 to 6.83; p<0.001) and CD4 <200 cells/mm3 vs HIV- (OR 8.09, 95{\%} CI 4.37 to 14.97; <0.001) had large independent associations with anaemia. There were large independent associations of CD4 <200 cells/mm3 vs HIV- (OR 7.18, 95{\%} CI 0.78 to 65.82; p=0.081) and co-trimoxazole and/or dapsone use (OR 5.69, 95{\%} CI 0.63 to 51.45; p=0.122) with moderate neutropenia. Conclusions: Anaemia was more common than neutropenia or thrombocytopenia in the HIV-infected Rwandan women. Future comparisons of haematological parameters in HIV-infected patients before and after antiretroviral therapy initiation are warranted.",
author = "Elisaphane Munyazesa and Ivan Emile and Eugene Mutimura and Hoover, {Donald R.} and Qiuhu Shi and McGinn, {Aileen P.} and Stephenson Musiime and Fred Muhairwe and Alfred Rutagengwa and Dusingize, {Jean Claude} and Kathryn Anastos",
year = "2012",
doi = "10.1136/bmjopen-2012-001600",
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TY - JOUR

T1 - Assessment of haematological parameters in HIV-infected and uninfected Rwandan women

T2 - A cross-sectional study

AU - Munyazesa, Elisaphane

AU - Emile, Ivan

AU - Mutimura, Eugene

AU - Hoover, Donald R.

AU - Shi, Qiuhu

AU - McGinn, Aileen P.

AU - Musiime, Stephenson

AU - Muhairwe, Fred

AU - Rutagengwa, Alfred

AU - Dusingize, Jean Claude

AU - Anastos, Kathryn

PY - 2012

Y1 - 2012

N2 - Objectives: Although haematological abnormalities are common manifestations of HIV infection, few studies on haematological parameters in HIV-infected persons have been undertaken in sub-Saharan Africa. The authors assessed factors associated with haematological parameters in HIV-infected antiretroviral- naïve and HIV-uninfected Rwandan women. Study design: Cross-sectional analysis of a longitudinal cohort. Setting: Community-based women's associations. Participants: 710 HIV-infected (HIV+) antiretroviral-naïve and 226 HIV-uninfected (HIV-) women from the Rwanda Women's Interassociation Study Assessment. Haematological parameters categorised as (abnormal vs normal) were compared by HIV status and among HIV+ women by CD4 count category using proportions. Multivariate logistic regression models using forward selection were fit. Results: Prevalence of anaemia (haemoglobin (Hb) <12.0 g/dl) was higher in the HIV+ group (20.5% vs 6.3%; p<0.001), and increased with lower CD4 counts: ≥350 (7.6%), 200-349 (16%) and <200 cells/mm3 (32.2%). Marked anaemia (Hb <10.0 g/dl) was found in 4.2% of HIV+ and none of the HIV- women (p<0.001), and was highest in HIV+ women with CD4 <200 cells/mm3 (8.4%). The HIV+ were more likely than HIV- women (4.2 vs 0.5%, respectively, p=0.002) to have moderate neutropenia with white blood cells < 2.0×103 cells/mm3 and 8.4% of HIV+ women with CD4 <200 cells/mm3 had moderate neutropenia. In multivariate logistic regression analysis, BMI (OR 0.87/kg/m2, 95% CI 0.82 to 0.93; p<0.001), CD4 200-350 vs HIV- (OR 3.59, 95% CI 1.89 to 6.83; p<0.001) and CD4 <200 cells/mm3 vs HIV- (OR 8.09, 95% CI 4.37 to 14.97; <0.001) had large independent associations with anaemia. There were large independent associations of CD4 <200 cells/mm3 vs HIV- (OR 7.18, 95% CI 0.78 to 65.82; p=0.081) and co-trimoxazole and/or dapsone use (OR 5.69, 95% CI 0.63 to 51.45; p=0.122) with moderate neutropenia. Conclusions: Anaemia was more common than neutropenia or thrombocytopenia in the HIV-infected Rwandan women. Future comparisons of haematological parameters in HIV-infected patients before and after antiretroviral therapy initiation are warranted.

AB - Objectives: Although haematological abnormalities are common manifestations of HIV infection, few studies on haematological parameters in HIV-infected persons have been undertaken in sub-Saharan Africa. The authors assessed factors associated with haematological parameters in HIV-infected antiretroviral- naïve and HIV-uninfected Rwandan women. Study design: Cross-sectional analysis of a longitudinal cohort. Setting: Community-based women's associations. Participants: 710 HIV-infected (HIV+) antiretroviral-naïve and 226 HIV-uninfected (HIV-) women from the Rwanda Women's Interassociation Study Assessment. Haematological parameters categorised as (abnormal vs normal) were compared by HIV status and among HIV+ women by CD4 count category using proportions. Multivariate logistic regression models using forward selection were fit. Results: Prevalence of anaemia (haemoglobin (Hb) <12.0 g/dl) was higher in the HIV+ group (20.5% vs 6.3%; p<0.001), and increased with lower CD4 counts: ≥350 (7.6%), 200-349 (16%) and <200 cells/mm3 (32.2%). Marked anaemia (Hb <10.0 g/dl) was found in 4.2% of HIV+ and none of the HIV- women (p<0.001), and was highest in HIV+ women with CD4 <200 cells/mm3 (8.4%). The HIV+ were more likely than HIV- women (4.2 vs 0.5%, respectively, p=0.002) to have moderate neutropenia with white blood cells < 2.0×103 cells/mm3 and 8.4% of HIV+ women with CD4 <200 cells/mm3 had moderate neutropenia. In multivariate logistic regression analysis, BMI (OR 0.87/kg/m2, 95% CI 0.82 to 0.93; p<0.001), CD4 200-350 vs HIV- (OR 3.59, 95% CI 1.89 to 6.83; p<0.001) and CD4 <200 cells/mm3 vs HIV- (OR 8.09, 95% CI 4.37 to 14.97; <0.001) had large independent associations with anaemia. There were large independent associations of CD4 <200 cells/mm3 vs HIV- (OR 7.18, 95% CI 0.78 to 65.82; p=0.081) and co-trimoxazole and/or dapsone use (OR 5.69, 95% CI 0.63 to 51.45; p=0.122) with moderate neutropenia. Conclusions: Anaemia was more common than neutropenia or thrombocytopenia in the HIV-infected Rwandan women. Future comparisons of haematological parameters in HIV-infected patients before and after antiretroviral therapy initiation are warranted.

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