A study of anemia in neonates receiving antiretroviral prophylaxis for prevention of mother-to-child HIV transmission compared between standard and high risk groups
Keywords:
PMTCT, standard risk, high risk, anemia, AZT, 3TC, NVPAbstract
Background: According to prevention of mother-to-child HIV transmission (PMTCT) program, neonates in standard risk group receive zidovudine (AZT) for 4 weeks and in high risk group receive AZT and lamivudine (3TC) and nevirapine (NVP). Both AZT and 3TC can cause anemia.
Objective: To compare prevalence and associated factors of anemia and transmission rate of HIV infection among neonates in standard and high risk group.
Methods: A retrospective observational study of neonates in PMTCT program at QSNICH during 2017-2019, was done. Results of complete blood count at 1-month-old age and results of anti-HIV at 18-month-old age were compared.
Results: There were 62 (68%) and 29 (32%) neonates in standard and high risk groups. The prevalence of anemia at 1-month-old age were 69% and 69% equally in both groups, (OR 0.982, 95% CI: 0.378-2.550) (p-value 0.97), which most of them had mild anemia (60% and 50% respectively, p-value 0.883). The proportion of anemia was higher in preterm (90.9%) than term neonates (66.3%) (OR 5, 95% CI: 4.479-5.619) (p-value 0.016) BW < 2,500 g (88.9%) than BW≥ 2,500 g (67.1%) (OR 3.9, 95% CI: 3.141-5.497) (p-value 0.011) and HC < P50 at 1-month-old age (86.4%) than HC ≥P50 (63.8%) (OR 3.6, 95% CI: 3.033-4.593) (p-value 0.046). Transmission rates of HIV infection were 0% and 3.4% in standard and high-risk groups (OR 1, 95% CI: 0.967-1.109) (p-value 0.141) sequentially.
Conclusions: The prevalence of anemia at 1-month-old age was not significantly different among neonates in standard and high risk groups. Preterm, BW < 2,500 g, HC at 1-monthold age < P50 were associated with anemia. Transmission rate of HIV infection in high risk group was 3.4%.
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