Anemia and thrombocytopenia in the cohort of HIV-infected adults in northwest Ethiopia: a facility-based cross-sectional study.

Background: Anemia and thrombocytopenia are frequent hematological abnormalities in patients with human immunodeficiency virus (HIV) infection and have been associated with increased morbidity and mortality. However, there is a paucity of data on the prevalence and correlates of these hematological abnormalities among HIV infected adults in Ethiopia. The aim of this study was to determine the prevalence and correlates of anemia and thrombocytopenia in a cohort of HIV-1 infected adults in northwest Ethiopia.

Methods: A total of 320 HIV-infected adults were enrolled into the study, from March 2016 to July 2016. Sociodemographic and clinical characteristics of the study participants were recorded. Blood samples were collected from each patient to determine hematological and immunological parameters. A binary logistic regression model was fitted to identify factors associated with each hematological abnormality. The odds ratio with a 95% confidence interval was calculated. A p-value <0.05 was considered statistically significant.

Results: Out of 320 HIV-1 positive participants, 203 (63.4%) were female. Overall, anemia was found in 25% (95% CI: 20.23 - 29.8%) of the study participants, of whom 2.5% (n=2) had severe and 21.2% (n=17) had moderate anemia. About 83.8% (67/80) anemic patients were on highly active antiretroviral therapy (HAART) for a minimum of six months, and 31 of them were receiving Zidovudine (AZT)-based HAART regimen. Multivariable logistic regression analysis showed that being HAART-naïve (AOR= 5.5, 95% CI: 1.5-19.9) and having CD4 count below 200 cells/µl (AOR= 2.4, 95% CI: 1.3-4.9) were independent and significant predictors of anemia. Thrombocytopenia was noted in 6.3% (95% CI: 3.58-8.9%) of the study participants. Sixty percent of thrombocytopenic (n=12) subjects were over the age of 40 years.

Conclusion: We found an overall high prevalence of anemia in the cohort of HIV-infected adults in northwest Ethiopia. HAART naïve subjects and those with CD4 count less than 200 cells/µl were found to be at higher risk for developing anemia. This data has an important implication for management of hematological abnormalities in HIV patients and highlights the need for early initiation of HAART to reduce the burden of anemia.