Loading…

Pathophysiology of Anemia in HIV-Infected Children Exposed to Malaria

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 ri...

Full description

Saved in:
Bibliographic Details
Published in:The American journal of tropical medicine and hygiene 2021-03, Vol.104 (3), p.1003-1012
Main Authors: Moraleda, Cinta, Aguilar, Ruth, Quintó, Llorenç, Nhampossa, Tacilta, Renom, Montserrat, Nhabomba, Augusto, Ruperez, María, Aponte, John J, Achtman, Ariel H, Mañú Pereira, María Del Mar, Schofield, Louis, Alonso, Pedro L, Macete, Eusebio, Menéndez, Clara
Format: Article
Language:English
Subjects:
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by
cites
container_end_page 1012
container_issue 3
container_start_page 1003
container_title The American journal of tropical medicine and hygiene
container_volume 104
creator Moraleda, Cinta
Aguilar, Ruth
Quintó, Llorenç
Nhampossa, Tacilta
Renom, Montserrat
Nhabomba, Augusto
Ruperez, María
Aponte, John J
Achtman, Ariel H
Mañú Pereira, María Del Mar
Schofield, Louis
Alonso, Pedro L
Macete, Eusebio
Menéndez, Clara
description 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.
doi_str_mv 10.4269/ajtmh.19-0783
format article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7941855</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2528503028</sourcerecordid><originalsourceid>FETCH-LOGICAL-c399t-e959d73cfd22175ca029345e77f83f54b63b09734caee63e076c0bd1cd21bcd63</originalsourceid><addsrcrecordid>eNp9kc9LwzAYhoMoOqdHr1Lw4qUzv9NchDGmGyh6UK8hTVOb0TYz6cT993Y6RT14-uD7Hl6-lweAEwRHFHN5oRddU42QTKHIyA4YICp4ijhlu2AAIcSp5EQcgMMYFxCiDCO0Dw4IYYQKlg3A9F53lV9W6-h87Z_XiS-TcWsbpxPXJrP5UzpvS2s6WySTytVFsG0yfVv62C86n9zqWgenj8Beqetoj7dzCB6vpg-TWXpzdz2fjG9SQ6TsUiuZLAQxZYExEsxoiCWhzApRZqRkNOckh1IQarS1nFgouIF5gUyBUW4KTobg8jN3ucobWxjbdkHXahlco8Naee3U70vrKvXsX5WQFGWM9QHn24DgX1Y2dqpx0di61q31q6gwzTjllMqsR8_-oAu_Cm1fT2HGIUWYQfw_hTMGCcSbrPSTMsHHGGz5_TKCaqNRfWhUSKqNxp4__dnzm_7yRt4BpW6YPA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2528503028</pqid></control><display><type>article</type><title>Pathophysiology of Anemia in HIV-Infected Children Exposed to Malaria</title><source>Open Access: PubMed Central</source><creator>Moraleda, Cinta ; Aguilar, Ruth ; Quintó, Llorenç ; Nhampossa, Tacilta ; Renom, Montserrat ; Nhabomba, Augusto ; Ruperez, María ; Aponte, John J ; Achtman, Ariel H ; Mañú Pereira, María Del Mar ; Schofield, Louis ; Alonso, Pedro L ; Macete, Eusebio ; Menéndez, Clara</creator><creatorcontrib>Moraleda, Cinta ; Aguilar, Ruth ; Quintó, Llorenç ; Nhampossa, Tacilta ; Renom, Montserrat ; Nhabomba, Augusto ; Ruperez, María ; Aponte, John J ; Achtman, Ariel H ; Mañú Pereira, María Del Mar ; Schofield, Louis ; Alonso, Pedro L ; Macete, Eusebio ; Menéndez, Clara</creatorcontrib><description>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] &lt; 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 &lt; 0.0001), Epstein-Barr virus infection (P &lt; 0.0001), bacteremia (P = 0.0060), a decreased risk of malaria (P &lt; 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 &lt; 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.</description><identifier>ISSN: 0002-9637</identifier><identifier>EISSN: 1476-1645</identifier><identifier>DOI: 10.4269/ajtmh.19-0783</identifier><identifier>PMID: 33534758</identifier><language>eng</language><publisher>United States: Institute of Tropical Medicine</publisher><subject>Anemia ; Anemia - epidemiology ; Anemia - etiology ; Anemia - physiopathology ; Case-Control Studies ; Child, Preschool ; Comorbidity ; Female ; HIV ; HIV Infections - complications ; HIV Infections - epidemiology ; Human immunodeficiency virus ; Humans ; Infant ; Infant, Newborn ; Infections ; Iron Deficiencies - complications ; Iron Deficiencies - physiopathology ; Malaria ; Malaria - complications ; Malaria - epidemiology ; Male ; Mozambique - epidemiology ; Pathophysiology ; Prevalence ; Risk Assessment ; Risk Factors</subject><ispartof>The American journal of tropical medicine and hygiene, 2021-03, Vol.104 (3), p.1003-1012</ispartof><rights>Copyright Institute of Tropical Medicine Mar 2021</rights><rights>The American Society of Tropical Medicine and Hygiene 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7941855/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7941855/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33534758$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Moraleda, Cinta</creatorcontrib><creatorcontrib>Aguilar, Ruth</creatorcontrib><creatorcontrib>Quintó, Llorenç</creatorcontrib><creatorcontrib>Nhampossa, Tacilta</creatorcontrib><creatorcontrib>Renom, Montserrat</creatorcontrib><creatorcontrib>Nhabomba, Augusto</creatorcontrib><creatorcontrib>Ruperez, María</creatorcontrib><creatorcontrib>Aponte, John J</creatorcontrib><creatorcontrib>Achtman, Ariel H</creatorcontrib><creatorcontrib>Mañú Pereira, María Del Mar</creatorcontrib><creatorcontrib>Schofield, Louis</creatorcontrib><creatorcontrib>Alonso, Pedro L</creatorcontrib><creatorcontrib>Macete, Eusebio</creatorcontrib><creatorcontrib>Menéndez, Clara</creatorcontrib><title>Pathophysiology of Anemia in HIV-Infected Children Exposed to Malaria</title><title>The American journal of tropical medicine and hygiene</title><addtitle>Am J Trop Med Hyg</addtitle><description>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] &lt; 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 &lt; 0.0001), Epstein-Barr virus infection (P &lt; 0.0001), bacteremia (P = 0.0060), a decreased risk of malaria (P &lt; 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 &lt; 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.</description><subject>Anemia</subject><subject>Anemia - epidemiology</subject><subject>Anemia - etiology</subject><subject>Anemia - physiopathology</subject><subject>Case-Control Studies</subject><subject>Child, Preschool</subject><subject>Comorbidity</subject><subject>Female</subject><subject>HIV</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - epidemiology</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infections</subject><subject>Iron Deficiencies - complications</subject><subject>Iron Deficiencies - physiopathology</subject><subject>Malaria</subject><subject>Malaria - complications</subject><subject>Malaria - epidemiology</subject><subject>Male</subject><subject>Mozambique - epidemiology</subject><subject>Pathophysiology</subject><subject>Prevalence</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><issn>0002-9637</issn><issn>1476-1645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kc9LwzAYhoMoOqdHr1Lw4qUzv9NchDGmGyh6UK8hTVOb0TYz6cT993Y6RT14-uD7Hl6-lweAEwRHFHN5oRddU42QTKHIyA4YICp4ijhlu2AAIcSp5EQcgMMYFxCiDCO0Dw4IYYQKlg3A9F53lV9W6-h87Z_XiS-TcWsbpxPXJrP5UzpvS2s6WySTytVFsG0yfVv62C86n9zqWgenj8Beqetoj7dzCB6vpg-TWXpzdz2fjG9SQ6TsUiuZLAQxZYExEsxoiCWhzApRZqRkNOckh1IQarS1nFgouIF5gUyBUW4KTobg8jN3ucobWxjbdkHXahlco8Naee3U70vrKvXsX5WQFGWM9QHn24DgX1Y2dqpx0di61q31q6gwzTjllMqsR8_-oAu_Cm1fT2HGIUWYQfw_hTMGCcSbrPSTMsHHGGz5_TKCaqNRfWhUSKqNxp4__dnzm_7yRt4BpW6YPA</recordid><startdate>20210301</startdate><enddate>20210301</enddate><creator>Moraleda, Cinta</creator><creator>Aguilar, Ruth</creator><creator>Quintó, Llorenç</creator><creator>Nhampossa, Tacilta</creator><creator>Renom, Montserrat</creator><creator>Nhabomba, Augusto</creator><creator>Ruperez, María</creator><creator>Aponte, John J</creator><creator>Achtman, Ariel H</creator><creator>Mañú Pereira, María Del Mar</creator><creator>Schofield, Louis</creator><creator>Alonso, Pedro L</creator><creator>Macete, Eusebio</creator><creator>Menéndez, Clara</creator><general>Institute of Tropical Medicine</general><general>The American Society of Tropical Medicine and Hygiene</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210301</creationdate><title>Pathophysiology of Anemia in HIV-Infected Children Exposed to Malaria</title><author>Moraleda, Cinta ; Aguilar, Ruth ; Quintó, Llorenç ; Nhampossa, Tacilta ; Renom, Montserrat ; Nhabomba, Augusto ; Ruperez, María ; Aponte, John J ; Achtman, Ariel H ; Mañú Pereira, María Del Mar ; Schofield, Louis ; Alonso, Pedro L ; Macete, Eusebio ; Menéndez, Clara</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c399t-e959d73cfd22175ca029345e77f83f54b63b09734caee63e076c0bd1cd21bcd63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Anemia</topic><topic>Anemia - epidemiology</topic><topic>Anemia - etiology</topic><topic>Anemia - physiopathology</topic><topic>Case-Control Studies</topic><topic>Child, Preschool</topic><topic>Comorbidity</topic><topic>Female</topic><topic>HIV</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - epidemiology</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infections</topic><topic>Iron Deficiencies - complications</topic><topic>Iron Deficiencies - physiopathology</topic><topic>Malaria</topic><topic>Malaria - complications</topic><topic>Malaria - epidemiology</topic><topic>Male</topic><topic>Mozambique - epidemiology</topic><topic>Pathophysiology</topic><topic>Prevalence</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Moraleda, Cinta</creatorcontrib><creatorcontrib>Aguilar, Ruth</creatorcontrib><creatorcontrib>Quintó, Llorenç</creatorcontrib><creatorcontrib>Nhampossa, Tacilta</creatorcontrib><creatorcontrib>Renom, Montserrat</creatorcontrib><creatorcontrib>Nhabomba, Augusto</creatorcontrib><creatorcontrib>Ruperez, María</creatorcontrib><creatorcontrib>Aponte, John J</creatorcontrib><creatorcontrib>Achtman, Ariel H</creatorcontrib><creatorcontrib>Mañú Pereira, María Del Mar</creatorcontrib><creatorcontrib>Schofield, Louis</creatorcontrib><creatorcontrib>Alonso, Pedro L</creatorcontrib><creatorcontrib>Macete, Eusebio</creatorcontrib><creatorcontrib>Menéndez, Clara</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The American journal of tropical medicine and hygiene</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Moraleda, Cinta</au><au>Aguilar, Ruth</au><au>Quintó, Llorenç</au><au>Nhampossa, Tacilta</au><au>Renom, Montserrat</au><au>Nhabomba, Augusto</au><au>Ruperez, María</au><au>Aponte, John J</au><au>Achtman, Ariel H</au><au>Mañú Pereira, María Del Mar</au><au>Schofield, Louis</au><au>Alonso, Pedro L</au><au>Macete, Eusebio</au><au>Menéndez, Clara</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pathophysiology of Anemia in HIV-Infected Children Exposed to Malaria</atitle><jtitle>The American journal of tropical medicine and hygiene</jtitle><addtitle>Am J Trop Med Hyg</addtitle><date>2021-03-01</date><risdate>2021</risdate><volume>104</volume><issue>3</issue><spage>1003</spage><epage>1012</epage><pages>1003-1012</pages><issn>0002-9637</issn><eissn>1476-1645</eissn><abstract>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] &lt; 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 &lt; 0.0001), Epstein-Barr virus infection (P &lt; 0.0001), bacteremia (P = 0.0060), a decreased risk of malaria (P &lt; 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 &lt; 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.</abstract><cop>United States</cop><pub>Institute of Tropical Medicine</pub><pmid>33534758</pmid><doi>10.4269/ajtmh.19-0783</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0002-9637
ispartof The American journal of tropical medicine and hygiene, 2021-03, Vol.104 (3), p.1003-1012
issn 0002-9637
1476-1645
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7941855
source Open Access: PubMed Central
subjects Anemia
Anemia - epidemiology
Anemia - etiology
Anemia - physiopathology
Case-Control Studies
Child, Preschool
Comorbidity
Female
HIV
HIV Infections - complications
HIV Infections - epidemiology
Human immunodeficiency virus
Humans
Infant
Infant, Newborn
Infections
Iron Deficiencies - complications
Iron Deficiencies - physiopathology
Malaria
Malaria - complications
Malaria - epidemiology
Male
Mozambique - epidemiology
Pathophysiology
Prevalence
Risk Assessment
Risk Factors
title Pathophysiology of Anemia in HIV-Infected Children Exposed to Malaria
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T12%3A57%3A01IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Pathophysiology%20of%20Anemia%20in%20HIV-Infected%20Children%20Exposed%20to%20Malaria&rft.jtitle=The%20American%20journal%20of%20tropical%20medicine%20and%20hygiene&rft.au=Moraleda,%20Cinta&rft.date=2021-03-01&rft.volume=104&rft.issue=3&rft.spage=1003&rft.epage=1012&rft.pages=1003-1012&rft.issn=0002-9637&rft.eissn=1476-1645&rft_id=info:doi/10.4269/ajtmh.19-0783&rft_dat=%3Cproquest_pubme%3E2528503028%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c399t-e959d73cfd22175ca029345e77f83f54b63b09734caee63e076c0bd1cd21bcd63%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2528503028&rft_id=info:pmid/33534758&rfr_iscdi=true