Prevalence of Anemia and Immunological Markers in HIV-Infected Patients on Highly Active Antiretroviral Therapy in Northeastern Nigeria

Abstract

BackgroundThere are conflicting reports on the impact of highly active antiretroviral therapy (HAART) in resolving hematological complications. Whereas some studies have reported improvements in hemoglobin and other hematological parameters resulting in reduction in morbidity and mortality of HIV patients, others have reported no improvement in hematocrit values of HAART-treated HIV patients compared with HAART-naïve patients.ObjectiveThis current study was designed to assess the impact of HAART in resolving immunological and hematological complications in HIV patients by comparatively analyzing the results (immunological and hematological) of HAART-naive patients and those on HAART in our environment.MethodsA total of 500 patients participated, consisting of 315 HAART-naive (119 males and 196 females) patients and 185 HAART-experienced (67 males and 118 females) patients. Hemoglobin (Hb), CD4+ T-cell count, total white blood count (WBC), lymphocyte percentage, plateletes, and plasma HIV RNA were determined.ResultsHAART-experienced patients were older than their HAART-naive counterparts. In HAART-naive patients, the incidence of anemia (packed cell volume [PCV] <30%) was 57.5%, leukopenia (WBC < 2.5), 6.1%, and thrombocytopenia < 150, 9.6%; it was, significantly higher compared with their counterparts on HAART (24.3%, 1.7%, and 1.2%, respectively). The use of HAART was not associated with severe anemia. Of HAART-naive patients, 57.5% had a CD4 count < 200 cells/μL in comparison with 20.4% of HAART-experienced patients (P < 0.001). The mean viral load log10 was significantly higher in HAART-naive than in HAART-experienced patients (P < 0.001). Total lymphocyte count < 1.0 was a significant predictor of <CD4 counts < 200 cells/μL in HAART-naïve patients, but this relationship was not observed in HAART-experienced patients.ConclusionHAART has the capability of reducing the incidence of anemia, other deranged hematological and immunological parameters associated with disease progression, and death in HIV-infected patients. Total lymphocyte count fails to predict CD4 count < 200 cells/μL in our cohort; thus, its use in the management and monitoring of HIV-infected patients in our settings is not reliable.

Anemia and Its Associated Risk Factors at the Time of Antiretroviral Therapy Initiation in Public Health Facilities of Arba Minch Town, Southern Ethiopia

“…The prevalence of anemia in this study was 52.3% which is in agreement with the study in China (51.9%) [11] and in Nigeria (57.5%) [12], but lower than that found by others in the country which reported 86.5% prevalence of anemia at base line [13]. However, our prevalence estimate was higher than other anemia prevalence studies in Northwest Ethiopia [10] and in the USA [14], which reported 35% and 39.7% prevalence of anemia at baseline among HIV patients respectively.…”

Cytopenias among ART-naive patients with advanced HIV disease on enrolment to care and treatment services at a tertiary hospital in Tanzania: A crosssectional study

“…24 On the other hand, our study reports a lower anaemia prevalance than several other studies that investigated anaemia prevalence among ART-naive patients. In a study from India, by Byomakesh et al, anaemia was found in 65.5% of the study participants, 14 while a prior study in rural Tanzania by Johannessen et al in 2011 reported a prevalence of 77.4% among ART-naive HIV-positive adults.…”

“…24 An important observation from available studies is that even with this great effect of ART on HIV-associated cytopenias, the reversal of these complications is usually incomplete. This suggests that the mechanisms underlying HIVassociated cytopenias are complex and can only be reversed partially with the use of ART.…”

Prevalence of Anaemia after Initiation of Antiretroviral Therapy among HIV-infected Patients Attending University of Calabar Teaching Hospital Calabar, Nigeria

“…Meanwhile in developing societies including Nigeria where nutritional deficiencies persist, anaemia on its own is yet to be effectively controlled and different vulnerable groups are being identified particularly women of childbearing age and children. It may therefore not be surprising that anaemia constitutes a major health challenge for people living with HIV infection in a country like Nigeria [6][7][8]. The anaemia occurring in HIV infection appears to be ameliorated by antiretroviral therapy, yet significant proportions of anaemic subjects are found among those who have commenced therapy [7][8][9][10].…”