Abstract:
Aims: To determine the incidence and severity of zidovudine-induced anaemia in HIVinfected
children initiated on anti-retroviral therapy in Jos, Nigeria.
Study Design: This was an observational cohort study.Place and Duration of Study: AIDS Prevention Initiative in Nigeria (APIN)-supported HIV
clinic of Jos University Teaching Hospital, Jos, Nigeria between April 2008 and March
2013.
Methodology: We followed up HIV-infected children initiated on highly active antiretroviral
therapy (HAART) for 12 months. We compared the haemoglobin level at
baseline, 3 months, 6 months and 12 months after initiation of HAART. We also compared
the haemoglobin level of those on zidovudine (ZDV) and stavudine (d4T)-containing
regimens.
Results: Three hundred and fifty-two (92.1%) patients were on zidovudine-containing
regimen while 30 (7.9%) were on stavudine-containing regimen. Three hundred and sixtyfive
(95.6%) were on cotrimoxazole while 17 (4.4%) were not on cotrimoxazole. The mean
haemoglobin level at baseline was 10.8±2.1g/dl for the ZDV group and 6.9±1.3g/dl for the
d4T group (P = .001). At baseline, 232 (60.7%) of the patients had anaemia while 26
(6.8%) had severe anaemia. At the end of the 12 months evaluation period, fifty-nine
(16.8%) of the patients on ZDV had Hb <8g/dl and were switched to d4T while 16 (4.6%)
received blood transfusion. The mean Hb level of ZDV group decreased from 10.8±2.1g/dl
to 9.3±1.8g/dl (P = .03) while that of d4T group increased from 6.9±1.3g/dl to 11.2±1.5g/dl
(P <.001).
Conclusion: ZDV-induced anaemia was common in HIV-infected children on HAART in
this study. Regular clinical and laboratory monitoring is necessary for early detection in
order to mitigate the harmful effect anaemia has on the health and survival of such
children.
