the practice and usefulness of bone marrow examinations in a cohort of human immunodeficiency virus infected children in South Africa: a descriptive study
Date
2012-01-11
Authors
Rowe, Biance
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Abstract
INTRODUCTION: Bone marrow examination (BME) is performed in Human Immunodeficiency Virus-infected (HIV+) children with haematologic abnormalities to exclude specific disease (SD).
AIMS: To describe the:
(1) indications for BME , (2) utility of BME to diagnose SD, (3) patient characteristics associated with SD or non-specific disease (NSD).
METHODS:
Design: Retrospective review.
Definitions:
SD: BME positive for opportunistic infection (OI) or HIV-related malignancy. NSD: HIV-related changes only.
RESULTS:
Eighty six BME’s were done. Suspected SD in 56/86(65.1%) was the most common clinical indication. Bicytopaenia(n=32) and isolated cytopaenia(n=31) were the most common haematologic indications. NSD 48/86 (55.8%) was a more common finding than SD 32/86 (37.2%). Granulomas, pure red cell aplasia and malignancy were the SD identified. Pre- highly active antiretroviral therapy (HAART), advanced stage, and not being virally suppressed were significantly associated with NSD.
CONCLUSION:
The yield of SD (37.2%) on BME is comparable to adult studies. HAART should be instituted before BME as NSD will be the most likely finding.
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Keywords
children with HIV