Sickle cell disease and HIV: a case highlighting management challenges for children in a resource-limited setting

J Int Assoc Provid AIDS Care. 2014 Mar-Apr;13(2):113-6. doi: 10.1177/2325957413508320. Epub 2013 Nov 20.

Abstract

Sickle cell disease (SCD) is a genetic disorder resulting from a mutation in the hemoglobin (Hb) gene. Sickle cell disease results in chronic anemia and a variety of acute and chronic complications that can lead to early mortality. A child with both SCD and HIV presents a management challenge, particularly in a resource-limited setting. In this case report, we describe the case of an 18-month-old Kenyan girl with SCD and HIV who developed a severe hypersensitivity reaction to first-line antiretroviral therapy (ART). Selecting an appropriate drug substitute for a child with SCD and HIV presents a management dilemma when the available options have problematic side effect profiles or are inaccessible or inappropriate according to national guidelines. The challenges in choosing an appropriate ART regimen for a child with SCD and HIV highlight the lack of data and scarcity of treatment options for pediatric patients.

Keywords: HIV; antiretroviral therapy; comorbidity; sickle cell disease.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Anemia / etiology
  • Anemia, Sickle Cell / complications
  • Anemia, Sickle Cell / therapy*
  • Anti-HIV Agents / adverse effects*
  • Disease Management
  • Disease Progression
  • Drug Hypersensitivity Syndrome / etiology*
  • Female
  • HIV Infections / complications
  • HIV Infections / drug therapy*
  • Health Resources / supply & distribution
  • Humans
  • Infant
  • Kenya

Substances

  • Anti-HIV Agents