Published December 8, 2025
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Low burden of clinically relevant anaemia and thrombocytopenia among adolescents living with HIV receiving tenofovir/lamivudine plus dolutegravir: the CIPHER-ADOLA study in Cameroon.

Creators

  • 1. Chantal BIYA International Reference Centre, for research on HIV/AIDS prevention and management, Yaoundé, Cameroon. fainguem_dine@yahoo.fr.
  • 2. Chantal BIYA International Reference Centre, for research on HIV/AIDS prevention and management, Yaoundé, Cameroon. romeobouba@yahoo.fr.
  • 3. Saint Camillus International University of Health Sciences, Rome, Italy. romeobouba@yahoo.fr.
  • 4. Chantal BIYA International Reference Centre, for research on HIV/AIDS prevention and management, Yaoundé, Cameroon.
  • 5. Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
  • 6. Essos Hospital Centre, Yaoundé, Cameroon.
  • 7. Mother and Child Centre, Chantal BIYA Foundation, Yaounde, Cameroon.
  • 8. Integrated Research, Education and Support Group, Yaounde, Cameroon.
  • 9. Cité Verte District Hospital, Yaoundé, Cameroon.
  • 10. Division of Disease, Epidemic and Pandemic Control, Ministry of Public Health, Yaoundé, Cameroon.
  • 11. Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy.
  • 12. University of Rome Tor Vergata
  • 13. Department of Health and Biomedical Sciences, University of Texas Rio Grande Valley, Brownsville, TX, USA.
  • 14. Global Funds Subvention Coordination Unit, Ministry of Public Health, Yaoundé, Cameroon.
  • 15. Department of Clinical Sciences, Higher Institute of Medical Technology, University of Douala, Douala, Cameroon.
  • 16. Pediatric Emergency Services, Amiens University Hospital, Amiens, France.
  • 17. Saint Camillus International University of Health Sciences, Rome, Italy.
  • 18. UNESCO Board of Multidisciplinary Biotechnology, University of Rome "Tor Vergata", Rome, Italy.
  • 19. Bambino Gesù Children Hospital, IRCCS, Rome, Italy.
  • 20. Scientific Institute for Research, Hospitalization and Healthcare
  • 21. Central Technical Group, National AIDS Control Committee (NACC), Ministry of Public Health, Yaoundé, Cameroon.

Description

Anaemia and thrombocytopenia adversely affect adolescent HIV outcomes, yet adolescent-specific data from the tenofovir/lamivudine/dolutegravir (TLD) era remain scarce, and access to full blood count (FBC) testing is limited in Cameroon. We evaluated the prevalence, severity, and factors associated with these cytopenias among adolescents living with HIV (ADLHIV) in the TLD era. Multicentre cross-sectional study was conducted among ADLHIV (10-19 years) receiving TLD in the CIPHER-ADOLA cohort in Cameroon. Full blood count, viral load (VL) and CD4-count were performed. Factors associated with anaemia and thrombocytopenia were ascertained. A total of 252 ADLHIV was enrolled (50.8% male, 83.3% were vertically infected, and 7.2% were underweighted). ART-duration and TLD-exposure were 10 [6-13] years and 26 [12-33] months, respectively. Concerning virological response, 71.4%, 13.1%, and 15.5% had a VL < 50, 50-999, and ≥ 1000, respectively. Overall, 102 (40.5%) were anaemic, with only 2.9% severe. Anaemia rate was twice higher in females (55.6%, p < 0.001); 64.1% with VL ≥ 1000 against 35.0% with VL < 50 (p = 0.003); 60.0% with CD4 < 200 against 35.4% with CD4 > 500 (p = 0.046). Regarding thrombocytopenia, the burden was low (6.7%), but higher among VL ≥ 1000 (p = 0.003). Multivariate analyses showed a threefold higher anaemia prevalence in females (aOR [95% CI: 3.406 [1.8952-5.940]), fivefold without formal education (0.191 [0.047-0.776]), threefold in VL ≥ 1000 copies/ml (0.338 [0.156-0.733]). Thrombocytopenia was fourfold more likely in males (aOR: 0.236 [0.072-0.774]) and sevenfold more likely in individuals with VL ≥ 1000 copies/mL (aOR: 0.140 [0.038-0.510]). In the TLD era, anaemia remains common but generally mild, and thrombocytopenia is uncommon. Cytopenias were associated with unsuppressed viral load, with a stronger association for anaemia in females. These findings support programmatic targeted haemovigilance prioritising adolescents with unsuppressed viral load, particularly females, in settings where access to FBC testing is limited. © 2025. The Author(s).
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