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

Abstract

Background: HIV is pandemic and remains as a public health concern for many decades. This infection though associated with many opportunistic infections and neoplasms, it is further complicated with marked hematological abnormalities. The aim of this study is to determine the magnitude & severity of hematological abnormalities in HIV infected individuals and also to analyze these abnormalities in correlation with the CD4 counts. We also compared these hematological abnormalities in patients on ART and those not on ART.Materials and Methods: The study was conducted for a period of one year, on 120 HIV positive cases including both patients on ART & not on ART. Controls with similar age and sex distribution was set up. The blood samples were collected and processed in an automated cell counter. The parameters were tabulated and analyzed with respect to CD4 count & ART status.Results: Among the total of 120 HIV cases, 77% had anemia, 21% had leucopenia and 5% had thrombocytopenia. The magnitude and severity of anemia, leucopenia, thrombocytopenia and other parameters was found to be more in patients not on ART, when compared to patients on ART. Similarly, the magnitude and severity of most of hematological abnormalities were inversely proportional to the CD4 count in non-ART cases but not with cases on ART.Conclusion: The basic hematological parameters can be used as a prospective screening test to assess the severity and progression of HIV infection when CD4 count is not available. These parameters can also be used to assess the response to anti-retroviral treatment. Therefore, these basic hematological investigations readily available at all medical centers are of great use while treating HIV infected patients.Asian Journal of Medical Sciences Vol.7(4) 2016 14-18

Effects of Highly Active Antiretroviral Treatment on Complete Blood Count Parameters

“…HGB, HCT, MCV and RDW-SD were significantly higher post HAART administration in a time dependent manner. The present study findings are consistent with studies by Thulasi et al [4] and Sullivan et al [31] who also found increases in red cell indices post-HAART administration. These findings are also consistent with the findings of Ogunbusuyi [32] who reported the prevalence of anaemia as higher in treatment naïve patients compared with those on HAART.…”

“…Calis and colleagues reported a prevalence of 3-38% moderate anaemia (Hb 8.0-9.9 g/dL) and 50-91% mild anaemia (Hb10.0-12.0 g/dL) among HIV infected individuals in tropical areas, which increases as the disease progresses and varies with age, gender and the definition used to establish anaemia [2]. The causes of anaemia in HIV infected individuals included decreased erythropoietin production, ineffective erythropoiesis, opportunistic infections, neoplasia and micronutrient deficiency [4]. Iron deficiency has also been reported as the commonest cause of nutritional anaemia among HIV infected individuals [3].…”

Evaluation of Hematological Parameters in HIV Reactive Patients on Antiretroviral Therapy and Treatment Naïve Patients: A Comparative Study

“…This probably indicates improvement in hemoglobin after ART. This observation was in concordance with study conducted by Omoregie et al Mathews et al and Thulasi et al, [15][16][17] the prevalence of anemia in their studies was as shown in above table.…”

“…This difference was found to be statistically significant. Although there is difference in overall prevalence of thrombocytopenia in the comparative studies, but the improvement in platelet count after ART was similar to studies conducted by Mathews et al, Enawgaw et al and Thulasi et al [14,16,17] Correlation of prevalence of anemia, leucopenia and thrombocytopenia with CD4 cell count: There was a significant correlation in the percentage of anemic patients and CD4 cell count. Moderate and severe anemia was more prevalent in patients with CD4 count less than 200 and those with CD4 count between 200-500, as compared to in patients with CD4 count more than 500.…”

“…8.14% in the study by Mathews et al, and 3.96% in group B. [16] In contrast to this, in a study by Enawgaw et al, and in a study by Thulasi et al, [14,17] prevalence of leucopenia was found to be slightly more in patients with ART. The difference might be due to different study population and different regime used for therapy.…”