This study assessed hematological abnormalities and associated factors among children with HIV who were either not on antiretroviral therapy (HAART-naive) or were on HAART. The study found that anemia, leukopenia, and thrombocytopenia were common in both groups. Severe immune suppression and gastroenteritis were associated with higher rates of anemia. Oral thrush and having a farmer or government-employed caregiver were linked to higher rates of leukopenia. The study concluded that hematological abnormalities are prevalent among children with HIV, especially those with low CD4 counts or comorbidities, and require careful investigation and management.