Neutropenia in HIV-Infected Kenyan Women Receiving Triple Antiretroviral Prophylaxis to Prevent Mother-to-Child HIV Transmission Is Not Associated with Serious Clinical Sequelae.
BACKGROUND
Absolute neutrophil counts (ANCs) are lower in East African adults. To assess the impact of lower ANCs, we reviewed data from HIV-infected Kenyan women receiving antiretroviral therapy antepartum and postpartum.


METHODS
The Kisumu Breastfeeding Study (KiBS) participants received an antiretroviral regimen from 34 weeks' gestation through 6 months postpartum. Measured ANCs and subsequent illnesses were reviewed. Adverse events (AEs) potentially attributable to neutropenia were identified, and ANCs were graded using the 2004 Division of AIDS table for Grading the Severity of AEs.


RESULTS
Among 478 women with ≥1 postpartum ANC measured, 298 (62.1%) women met criteria for an AE (<1.3 × 10(9) cells/L). Of those, 38 (12.5%) women experienced a nonlife-threatening illness potentially attributable to neutropenia.


CONCLUSIONS
More than half of KiBS women met criteria for neutropenia. The mild clinical experience of most participants with low ANCs supports that these values might be typical for this population and may not result in adverse clinical sequelae.
Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA aiuliano@cdc.gov.
A Danielle
AD
Iuliano
Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Paul J
PJ
Weidle
Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
John T
JT
Brooks
Kenya Medical Research Institute, Kisumu, Kenya.
Rose
R
Masaba
Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA ICF International, Atlanta, GA, USA.
Sonali
S
Girde
Kenya Medical Research Institute, Kisumu, Kenya.
Richard
R
Ndivo
Kenya Medical Research Institute, Kisumu, Kenya.
Paul
P
Ogindo
Kenya Medical Research Institute, Kisumu, Kenya.
Paul
P
Omolo
Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA Kenya Medical Research Institute (KEMRI)/CDC, Kisumu, Kenya.
Clement
C
Zeh
Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA Kenya Medical Research Institute (KEMRI)/CDC, Kisumu, Kenya.
Timothy K
TK
Thomas
D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007630:Kenya / Q000453:epidemiology; D007958:Leukocyte Count; D008297:Male; D009503:Neutropenia / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D009504:Neutrophils / Q000166:cytology; D065129:Pre-Exposure Prophylaxis; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D037841:Pregnant People; D055815:Young Adult
D019380:Anti-HIV Agents
African; HIV infected; absolute neutrophil counts; adverse events; pregnant