Hematologic Abnormalities in Treatment-naïve HIV Patients

Abstract

Objectives: Hematologic abnormalities, indicated by a deranged full blood count, are common manifestations and important prognostic tools for human immunodeficiency virus (HIV) infection and AIDS. This study aimed to determine the prevalence of cytopenia and its relationship to the degree of immunosupression in HIV treatment-naïve patients. Methods: This was a cross-sectional study of treatment-naïve HIV-infected clients who enrolled at the HIV clinic of Lagos State University Teaching Hospital (LASUTH) between December 2009 and June 2010. Participants had samples taken for full blood count and CD4 counts, which are free routine pre-requisite and pre-treatment evaluations done for all registered HIV patients at LASUTH. They were asked to fill the structured questionnaires to obtain demographic data, with assistance if necessary. Results: A total of 205 cases were reviewed: 24.2% had anemia (PCV , 30%), 26.8% had leucopenia (white blood cell ,4,000/L) and 16.1% had thrombocytopenia (platelet count ,150,000/L) at enrollment. The degree of cytopenia was directly related to the degree of immunosupression. Conclusion: About one-fifth of HIV treatment-naïve patients were cytopenic at enrollment and the degree of cytopenia was directly related to the degree of immunosupression. It is necessary to investigate various causes of cytopenia in these patients so as to administer a specific intervention.

Hematological abnormalities in HIV infected individuals in correlation to CD4 counts and ART status

“…As encountered by Akinsegun Akinbami et al, 5 in the present study, we found 25 out of 120 cases (21%) having leucopenia ( Table 1). Among the 44 cases which were not on ART, mild to moderate leucopenia was found in 19% (N=6/44) of cases.…”

“…This was done to sort out the HIV cases by disease severity. A similar CD4 intervals were used by Akinbamiet al, 5 in his study "Hematological abnormalities in treating naïve HIV patients" to bring out the relationship between varying degrees of CD4 count and cytopenias.…”

“…Presence of specific antiplatelet antibodies and direct infection of megakaryocytes by HIV are also being hypothesized. 5 We encountered bicytopenia in 20% (24/120) of cases and only one pancytopenia. Byomakesh Dikshit et al, 11 encountered Pancytopenia in 6% (12/200) of cases in their cohort study.…”

The prevalence of HIV seropositivity and associated cytopenias in full blood counts processed at an academic laboratory in Soweto, South Africa.

“…The impact on haematology services is singularly notable because of the numerous haematological complications of HIV infection, which occur secondary to effects of the virus itself, as a result of associated opportunistic infections/malignancies, or as adverse drug effects. [1] Several studies have reported the prevalence of haematological complications in HIV-seropositive patients, [2][3][4][5][6][7] with variables such as disease stage and exposure to antiretroviral therapy (ART) being important determinants. [8] However, there is a paucity of published SA data in this regard, despite the fact that the burden of HIV infection in SA is among the highest in the world.…”

“…[9] Documenting the SA experience in this respect is important, as the prevalence of some cytopenias has been shown to vary geographically, with anaemia being more prevalent among treatment-naive patients with AIDS from Africa than among those from Asia or the Americas. [5] Furthermore, geographical differences have been reported within Africa, with the prevalence of anaemia in patients with immunological AIDS (iAIDS) being 32.2%, 49.3% and 58.0% in Rwanda, [6] Uganda [7] and Nigeria, [4] respectively. The prevalence of cytopenias in SA patients is therefore of interest.…”