Pathophysiology of Anemia in HIV-Infected Children Exposed to Malaria.

Cinta Moraleda; Ruth Aguilar; Llorenç Quintó; Tacilta Nhampossa; Montserrat Renom; Augusto Nhabomba; María Ruperez ORCID logo; John J Aponte; Ariel H Achtman; María Del Mar Mañú Pereira; +4 more... Louis Schofield; Pedro L Alonso; Eusebio Macete; Clara Menéndez; (2021) Pathophysiology of Anemia in HIV-Infected Children Exposed to Malaria. The American Journal of Tropical Medicine and Hygiene, 104 (3). pp. 1003-1012. ISSN 0002-9637 DOI: 10.4269/ajtmh.19-0783
Copy

Anemia is a common condition in HIV-infected children; however, its pathophysiology and the contribution of frequent causes of anemia such as iron deficiency (ID) and malaria are poorly understood. We carried out an ancillary study on the effect of HIV on anemia as part of a case-control study on risk factors of anemia among Mozambican children aged 1-59 months with documented HIV status. Of them, 390 children were admitted to the hospital with anemia (hemoglobin [Hb] < 11 g/dL), whereas 272 children without anemia (Hb ≥ 11 g/dL) were recruited in the community. We assessed differences by HIV status in the presentation of anemia etiological factors and the effect of HIV infection on the association of each factor with anemia. Among the 99 HIV-infected and 563 uninfected children included, HIV-infected anemic children had an increased risk of undernutrition (P < 0.0001), Epstein-Barr virus infection (P < 0.0001), bacteremia (P = 0.0060), a decreased risk of malaria (P < 0.0001), and a similar risk of ID (P = 0.7371) compared with anemic-uninfected children. HIV-infected children were significantly less likely to have anemia associated with Plasmodium falciparum hyperparasitemia (P = 0.0444) and had a lower prevalence of parasitemia in the bone marrow (BM) (P < 0.0001) than anemic-uninfected children. Levels of BM erythropoiesis and dyserythropoiesis were comparable between groups. These findings suggest that the pathophysiology of anemia among HIV-infected malaria-exposed children is not related to HIV-specific effects. For unclear reasons, HIV-infected children had reduced risk of malaria infection, whereas ID prevalence was comparable in HIV-infected and uninfected children, suggesting that iron supplementation recommendations should not be different in HIV-infected children.


picture_as_pdf
[14761645 - The American Journal of Tropical Medicine and Hygiene] Pathophysiology of Anemia in HIV-Infected Children Exposed to Malaria.pdf
subject
Published Version
Available under Creative Commons: NC-ND 3.0

View Download

Atom BibTeX OpenURL ContextObject in Span Multiline CSV OpenURL ContextObject Dublin Core Dublin Core MPEG-21 DIDL EndNote HTML Citation JSON MARC (ASCII) MARC (ISO 2709) METS MODS RDF+N3 RDF+N-Triples RDF+XML RIOXX2 XML Reference Manager Refer Simple Metadata ASCII Citation EP3 XML
Export

Downloads