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

Figures & data

Table 1 Socio-Demographic Characteristics of the Study Participants Attending HUCSH from July to September 2020, Hawassa, Ethiopia (n = 273)

Variables	Category	Sex(N=273)		p-value
		Male	Female
Age in years	<5	8 (2.9)	8 (2.9)	0.4
	5–11	75 (27.5)	68 (24.9)
	12–14	50 (18.3)	64 (23.4)
Residence	Urban	107 (39.2)	117 (42.9)	0.5
	Rural	26 (9.5)	23 (8.4)
Educational status	Unable to read and write	22 (8.1)	16 (5.9)	0.5
	Primary	104 (38.1)	115 (42.1)
	Secondary	7 (2.5)	9 (3.3)
Family size	≤3	21 (7.7)	25 (9.2)	0.7
	4–7	93 (34.1)	99 (36.3)
	>7	19 (7.0)	16 (5.9)
Primary caretaker	Mother or father	99 (36.2)	114 (41.8)	0.2
	Other	35 (12.8)	26 (9.5)
Family income(in Ethiopian birr per month)	<1000	58 (21.2)	53 (19.4)	0.4
	≥1000	75 (27.5)	87 (31.9)

Table 2 Clinical Characteristics of HAART Experienced HIV Positive Children Attending HUCSH (N = 273)

Variables	Category	Sex(N=273)
		Male	Female
WHO stage	1 and 2	129 (47.3)	140 (51.3)
	3 and 4	4 (1.4)	0
HAART duration(in years)	<10	92 (46.5)	106 (53.5)
	≥10	41 (54.7)	34 (45.3)
Malaria	Yes	0	1
	No	133 (48.7)	139 (50.9)
Temperature C°	≤37	126 (46.2)	135 (49.5)
	>37	7 (2.6)	5 (1.8)
Other medication	No	100 (36.6)	129
	Co-trimoxazole	23 (8.4)	8 (2.9)
	Amoxicillin	3 (2.9)	2 (0.7)
	Augmentin	1 (0.4)	1 (0.4)
	Nutritional supplement	6 (2.1)	0
ART Drugs	AZT/3TC/EVF	120 (44.0)	124 (45.4)
	ABC/3TC/CALETR	9 (3.3)	11 (4.0)
	TDF/3TC/CALETRA	4 (1.5)	5 (1.8)
Co-medication	Yes	100 (43.7)	129 (56.3)
	No	33 (75.0)	11 (25.0)
CD4 cell cells/mm^3	≤350	23 (8.4)	12 (4.4)
	350–500	16 (5.8)	9 (3.3)
	>500	94 (34.4)	119 (43.6)
Viral load	ND	68 (24.9)	95 (34.8)
	≤150	32 (11.7)	21 (7.7)
	>150	33 (12.1)	24 (8.8)
HAZ	≤-2	49 (18.0)	50 (18.2)
	>-2	84 (30.8)	90 (33.0)
WAZ	<-2	20 (7.3)	7 (2.6)
	≥-2	113 (41.4)	133 (48.7)

Abbreviations: HAZ, Height-Age Z score; WAZ, Weight-Age Z score.

Figure 1 Distribution of cytopenia among HIV positive children on HAART at HUCSH (N = 273).

Figure 2 Gender wise distribution of cytopenia among HIV positive children on HAART at HUCSH (N = 273).

Figure 3 Distribution of cytopenia among HIV positive children on HAART at HUCSH stratified by age (N = 273).

Table 3 Cytopenia Distribution of Study Participants by CD4 Percentage and Viral Load of HAART Experienced HIV Positive Children at HUCSH (N = 273)

	CD4 Percentage				Viral Load
Variables	>25	15–25	<15	P-value	ND	<150	≥150
Anemia	18 (10.9)	8 (11.1)	5 (13.9)	0.85	13 (8.0)	4 (7.5)	14 (24.5)
Leucopenia	19 (11.5)	10 (13.9)	10 (27.8)	0.02	18 (11.0)	7 (13.2)	14 (24.5)
Leucocytosis	6 (3.6)	7 (9.7)	0	0.02	6 (3.7)	5 (9.4)	2 (3.5)
Neutropenia	30 (18.2)	13 (18.1)	7 (19.4)	0.9	29 (17.8)	8 (15.4)	13 (22.8)
Lymphopenia	11 (6.7)	6 (8.3)	10 (27.7)	0.001	4 (2.5)	6 (11.3)	17 (29.8)
Thrombocytopenia	5 (3.0)	2 (2.8)	4 (11.1)	0.07	5 (3.1)	1 (1.9)	5 (8.8)
Pancytopenia	5 (3.0)	1 (1.4)	2 (5.5)	0.5	1 (0.01)	1 (1.9)	6 (10.5)

Abbreviations: ND, Not detectable; CD, cluster of differentiation.

Table 4 Correlation of Hematological Parameters with a Viral Load of HAART-Experienced HIV-Positive Children at HUCSH (N = 273)

Hematological Parameter	Mean ± SD/ Median(IQR)	Pearson Correlation, r	P-value
Hb	13.1 (1.5)	−0.2	0.009
RBC	4.1 (0.6)	−0.2	0.01
WBC(Median)	6.4 (4.9–8.4)	−0.1	0.08
Neutrophil	46.0 (35.2–55.0)	0.04	0.5
LYM	41.3 (32.3–51.4)	−0.3	<0.001
Platelet	320 (258–366)	−0.2	0.004

Abbreviations: IQR, Interquartile range; Hb, hemoglobin; LYM, Lymphocyte; RBC, Red blood cell; SD, Standard deviation; WBC, White blood cell.

Table 5 Factors Associated with Cytopenia Among HAART Experienced HIV Positive Children at HUCSH (N = 273)

Variable	Category	COR(95% CI)	p-value	AOR(95% CI)	p-value
Gender	Male	1.4 (0.8–2.4)	0.2*	1.1 (0.6–2.0)	0.8
	Female	1		1
Residence	Urban	1		1
	Rural	2.2 (1.2–4.3)	0.02*	2.6 (1.3–5.2)	0.01**
Family size	≥3	1		1
	<3	1.8 (0.9–3.5)	0.09*	1.8 (0.9–3.7)	0.1
Baseline CD4%	<15	1.9 (0.9–3.7)	0.09	1.5 (0.7–3.2)	0.3
	15–25	1.2 (0.6–2.6)	0.6	1.2 (0.6–2.7)	0.6
	>25	1		1
Viral	ND	0.5 (0.3–0.8)	0.008*	0.5 (0.3–0.9)	0.03**
	Detectable	1		1
WHO stage	1 and 2	0.1 (0.01–1.2)	0.07*	0.1 (0.01–1.4)	0.09
	3 and 4	`1		1
Co-medication	Yes	0.6 (0.3–1.1)	0.1	1.2 (0.2–9.3)	0.8
	No	1		1
Additional medication	Yes	0.6 (0.3–1.2)	0.1*	0.7 (0.3–1.4)	0.3
	No	1		1

Notes: *P-value< 0.25; **P-value <0.05.

Abbreviations: CD, Cluster of differentiation; ND, None detectable; WHO, World health organization; HAZ, height- Age-Z score.