Prevalence and impact of sickle cell trait on the clinical and laboratory parameters of HIV infected children in Lagos, Nigeria

Abstract

Introduction: sickle cell disease and HIV infection are prevalent in sub-Saharan Africa. While Haemoglobin S (HbS) contributes to significant morbidity and mortality in the homozygous or double heterozygous states, in the carrier state it confers a survival advantage in disease conditions such as malaria. However the interaction between sickle haemoglobin and HIV infection, especially in children remains largely unknown. This study aimed to assess the prevalence and impact of sickle cell trait on the clinical and laboratory parameters of HIV infected children in Lagos, Nigeria.

Methods: a cross-sectional study among HIV infected children in an HIV treatment centre in Lagos, Nigeria. Socio-demographic and clinical characteristics were obtained and blood sample collected for haemoglobin electrophoresis, HIV RNA viral load and haematologic profile. Data was analysed with SPSS version 20.

Results: the prevalence of sickle cell trait was 18.8% among the 208 study participants, with none having sickle cell disease (SCD). Participants with SCT were significantly younger (OR = 4.0 95% CI (1.74-9.24)), more likely to be from the Yoruba ethnic group (OR = 3.3 95% CI [1.45-7.52)), had more opportunistic infections (OR = 2.4 95% CI (1.18-5.03), and lower mean HIV RNA viral load (p = 0.05) at baseline. However response to HIV care and treatment was similar in both groups of participants.

Conclusion: the finding of absence of SCD, low prevalence of SCT, and lower HIV viraemia in HIV infected children with SCT may have implications for childhood survival which requires further clarification in future studies.