Profile of HIV-Infected Hispanics with Pancytopenia

Abstract

Pancytopenia is seen in late HIV infection; it is associated with medical complications and with decreased survival. We determined the prevalence of pancytopenia at baseline in a cohort of HIV-positive Hispanics living in Puerto Rico, and compared their socio-demographic, immunological and clinical characteristics. A total of 1202 patients enrolled between 2000 and 2010 were included. They were grouped according to pancytopenia status, defined by having: platelets <150,000 μL, white cell count <4000 μL, and hemoglobin <12 g/dL (women) or <13 g/dL (men). Differences were evaluated using Student’s t-test, Chi-square test and Kaplan-Meier method. The prevalence of pancytopenia was 8.7%. Patients with pancytopenia had lower BMI and lower CD4 count, as well as higher HIV viral load and higher proportions of unemployment, clinical AIDS and antiretroviral treatment (ART) use (p < 0.05). One-year mortality rate was significantly higher in patients with pancytopenia (18.1% vs. 5.1%, p < 0.001). When stratifying for ART this association persisted for patients who did not receive ART (41.4% vs. 5.2%, p < 0.001), but it was not seen in patients who received treatment (9.2% vs. 5.6%, p = 0.196). Pancytopenia was associated with elements of advanced stages of HIV. ART could reduce the mortality of HIV-patients with pancytopenia to levels comparable to patients without the disorders.

Prevalence of cytopenia and its associated factors among HIV infected adults on highly active antiretroviral therapy at Mehal Meda Hospital, North Shewa Zone, Ethiopia

“…Pancytopenia in this study was 1% (95% CI: 0.4%-2%), which is nearly in agreement with a study conducted by Firnhaber C et al (0.3%) [47]. However, a study from Jimma reports no pancytopenia found [19] and studies conducted by Bukar A et al [31] and Santiago-Rodríguez EJ et al [48] reported 8% and 8.7% pancytopenia, respectively, which is higher than our finding. The difference might be due to variation in sample size and design of the studies.…”

Magnitude and associated factors of cytopenias among antiretroviral therapy naïve Human Immunodeficiency Virus infected adults in Dessie, Northeast Ethiopia

“…HIV-associated hematologic abnormalities in these individuals may involve direct HIV infection of bone marrow progenitors, abnormal regulation of hematopoiesis and/or autoimmune phenomena [33, 34]. Previous studies conducted to investigate hematological abnormalities among treatment–naïve HIV patients indicated that the degree of cytopenias were directly related to advancement of HIV disease where the immune system is substantially debilitated, viral replication has not been controlled and opportunistic infections are rampant [21, 35, 36]. In this study, CD4 T-cell count from 200–349 cells/mm 3 and <200 cells/mm 3 were identified as significant independent predictors for presence of any cytopenias.…”

Prevalence of anemia before and after initiation of antiretroviral therapy among HIV infected patients at Black Lion Specialized Hospital, Addis Ababa, Ethiopia: a cross sectional study

“…In general, in the advanced stage of the disease, the blood cell counts were lower than the early stage of the diseases. This might be due to the increasing trend in the frequency of bone marrow abnormalities with progressive immunologic deterioration and advanced disease due to HIV [ 19 , 20 ].…”