title: Assessment of haematological parameters in HIV-infected and uninfected Rwandan women: a cross-sectional study.
abstract: OBJECTIVE
  Although haematological abnormalities are common manifestations of HIV infection, few studies on haematological parameters in HIV-infected persons have been undertaken in sub-Saharan Africa. The authors assessed factors associated with haematological parameters in HIV-infected antiretroviral-naïve and HIV-uninfected Rwandan women.
  
  
  METHODS
  Cross-sectional analysis of a longitudinal cohort.
  
  
  METHODS
  Community-based women's associations.
  
  
  METHODS
  710 HIV-infected (HIV+) antiretroviral-naïve and 226 HIV-uninfected (HIV-) women from the Rwanda Women's Interassociation Study Assessment. Haematological parameters categorised as (abnormal vs normal) were compared by HIV status and among HIV+ women by CD4 count category using proportions. Multivariate logistic regression models using forward selection were fit.
  
  
  RESULTS
  Prevalence of anaemia (haemoglobin (Hb) <12.0 g/dl) was higher in the HIV+ group (20.5% vs 6.3%; p<0.001), and increased with lower CD4 counts: ≥350 (7.6%), 200-349 (16%) and <200 cells/mm(3) (32.2%). Marked anaemia (Hb <10.0 g/dl) was found in 4.2% of HIV+ and none of the HIV- women (p<0.001), and was highest in HIV+ women with CD4 <200 cells/mm(3) (8.4%). The HIV+ were more likely than HIV- women (4.2 vs 0.5%, respectively, p=0.002) to have moderate neutropenia with white blood cells <2.0×10(3) cells/mm(3) and 8.4% of HIV+ women with CD4 <200 cells/mm(3) had moderate neutropenia. In multivariate logistic regression analysis, BMI (OR 0.87/kg/m(2), 95% CI 0.82 to 0.93; p<0.001), CD4 200-350 vs HIV- (OR 3.59, 95% CI 1.89 to 6.83; p<0.001) and CD4 <200 cells/mm(3) vs HIV- (OR 8.09, 95% CI 4.37 to 14.97; <0.001) had large independent associations with anaemia. There were large independent associations of CD4 <200 cells/mm(3) vs HIV- (OR 7.18, 95% CI 0.78 to 65.82; p=0.081) and co-trimoxazole and/or dapsone use (OR 5.69, 95% CI 0.63 to 51.45; p=0.122) with moderate neutropenia.
  
  
  CONCLUSIONS
  Anaemia was more common than neutropenia or thrombocytopenia in the HIV-infected Rwandan women. Future comparisons of haematological parameters in HIV-infected patients before and after antiretroviral therapy initiation are warranted.
authors.affiliation: Department of Quality Control,  Institute of HIV/AIDS and Disease Prevention and Control (IHDPC) National Reference Laboratory Division,  Rwanda Biomedical Center (RBC), Kigali,  Rwanda.
authors.forename: Elisaphane
authors.initials: E
authors.lastname: Munyazesa
authors.forename: Ivan
authors.initials: I
authors.lastname: Emile
authors.forename: Eugene
authors.initials: E
authors.lastname: Mutimura
authors.forename: Donald R
authors.initials: DR
authors.lastname: Hoover
authors.forename: Qiuhu
authors.initials: Q
authors.lastname: Shi
authors.forename: Aileen P
authors.initials: AP
authors.lastname: McGinn
authors.forename: Stephenson
authors.initials: S
authors.lastname: Musiime
authors.forename: Fred
authors.initials: F
authors.lastname: Muhairwe
authors.forename: Alfred
authors.initials: A
authors.lastname: Rutagengwa
authors.forename: Jean Claude
authors.initials: JC
authors.lastname: Dusingize
authors.forename: Kathryn
authors.initials: K
authors.lastname: Anastos