Thrombocytopenia according to Antiretroviral Drug Combinations, Viremia and CD4 Lymphocytes among HIV-Infected Patients in Cameroon A Snapshot from the City of Yaoundé

Nka, Alex Durand; Sosso, Samuel Martin; Fokam, Joseph; Bouba, Yagaï; Této, Georges; Kamgaing, Rachel; Tiga, Aline; Yimga, Junie Flore; Nukenine, Elias Nchiwan; Nanfack, Aubin; Takou, Désiré; Aroga, Zélateur; Colizzi, Vittorio; Ndjolo, Alexis

doi:10.21203/rs.2.9478/v1

Cited by 6 publications

(10 citation statements)

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“…The difference might be due to variation in the definition of thrombocytopenia, study design and size of the study population. Regarding the severity of thrombocytopenia, the predominant form was mild thrombocytopenia which is consistent with other studies [45,46].…”

Section: Discussionsupporting

confidence: 92%

“…The possible causes of thrombocytopenia could be immune-mediated platelet destruction, impaired platelet production by the infected magakaryocytes of the bone marrow, or myelosuppression effects of medications. On the other hand, the prevalence of this study was higher than studies done in northwest Ethiopia (4.1% and 6.3%) [15,17], Jimma (6.9%) [19], Addis Ababa (5.7%) [45], and Yaoundé, Cameroon (6.9%) [46], and lower than studies in Ghana (18.5%) [42] and Kaduna State, Nigeria (24%) [26,31]. The difference might be due to variation in the definition of thrombocytopenia, study design and size of the study population.…”

Section: Discussioncontrasting

confidence: 77%

See 1 more Smart Citation

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

Gebreweld

Fiseha

Girma³

et al. 2020

PLoS ONE

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 77%

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

Gebreweld

Fiseha

Girma³

et al. 2020

PLoS ONE

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“…This incidence could be explained by the peripheral destruction of platelets due to HIV infection following the existence of antiplatelet autoantibodies specifically directed against certain antigenic determinants of the platelet membrane. The existence of these antiplatelet autoantibodies usually results from a cross-reactive humoral reactivity between viral and platelet components, in particular gp120 and gp IIb/IIIa [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of hepatic fibrosis in HIV/HCV co-infected individuals in Yaoundé, Cameroon: usefulness of APRI score in resource-constrained settings

et al. 2020

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Background HIV infection exacerbates the prognosis of HCV infection, with a faster progression of hepatitis. Hepatic fibrosis is the major disruption of the hepatic tissue architecture characterized by anarchic deposition and excess of the extracellular matrix. The objective of this study was to evaluate hepatic fibrosis in HIV/HCV co-infected individuals as compared to HCV mono-infected. Methods A total of 97 participants (mean age 60.2 ± 14.3 years and 0.76 male/female sex ratio) was enrolled in a study conducted in Yaoundé, Cameroon from November 2018 to January 2019. Liver fibrosis was assessed by the APRI score (Aspartate Aminotransferase or AST/Platelet Ratio Index) which identifies the stage of fibrosis as classified by the Metavir system (F0 to F4). CD4 counts and plasmatic HIV viral load of HIV/HCV co-infected individuals were determined and the correlation between hepatic fibrosis and immuno-virological status established. Statistical analysis was done using Microsoft Excel 2016 and EpiInfo7 software. Results A high proportion (63.6%) of HIV/HCV co-infected participants had an abnormal AST level: 73.6 ± 45.8 IU/L as compared to 58.5 ± 39.3 IU/L (59.3%) among HCV mono-infected participants. The frequency of thrombocytopenia was 63.6% with a mean platelet count of 137 ± 50 × 103 IU/L in HIV/HCV co-infected participants as compared to 176 ± 67 × 103 IU/L in HCV mono-infected participants (38.4%). The progression of hepatic fibrosis in participants with clinically significant fibrosis: F2, F3 and F4 was higher among HIV/HCV co-infected and the mean APRI score was 1.7 ± 1.4 versus 1 ± 0.8 among HCV mono-infected (26.7%). All participants (100%) with detectable HIV viral load had clinically significant fibrosis compared to 33.4% in those with undetectable HIV viral load (p = 0.55). Only 42.9% participants with CD4 > 500 cells/μL had clinically significant fibrosis (p = 0.72) while 100% participants with CD4 < 200 cells/μL had clinically significant fibrosis (p = 0.58). Conclusions A high level of AST combined with thrombocytopenia (APRI score > 1.5) is an indicator of hepatic fibrosis in HIV/HCV co-infected individuals. Because of its non-invasive and less costly nature, the APRI score can be a suitable biomarker to monitor hepatic fibrosis in HIV/HCV co-infected individuals in resource constrained settings.

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“…This incidence could be explained by the peripheral destruction of platelets due to HIV infection following the existence of antiplatelet autoantibodies speci cally directed against certain antigenic determinants of the platelet membrane. The existence of these antiplatelet autoantibodies usually results from a cross-reactive humoral reactivity between viral and platelet components, in particular gp120 and gp IIb/IIIa (17,18).…”

Section: Resultsmentioning

confidence: 99%

Evaluation of hepatic fibrosis in HIV/HCV Co-infected individuals in Yaoundé, Cameroon: Usefulness of APRI score in resource-constrained settings

Dobseu

Nanfack

Kowo³

et al. 2020

Preprint

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Background: HIV infection exacerbates the prognosis of HCV infection, with a faster progression of hepatitis. Hepatic fibrosis is the major disruption of the hepatic tissue architecture characterized by anarchic deposition and excess of the extracellular matrix. The objective of this study was to evaluate hepatic fibrosis in HIV/HCV co-infected individuals as compared to HCV mono-infected. Methods: A total of 97 participants (mean age 60.2±14.3 years and 0.76 male/female sex ratio) was enrolled in a study conducted in Yaoundé, Cameroon from November 2018 to January 2019. Liver fibrosis was assessed by the APRI score (Aspartate Aminotransferase or AST/Platelet Ratio Index) which identifies the stage of fibrosis classified by the Metavir system (F0 to F4). CD4 counts and plasmatic HIV viral load of HIV/HCV co-infected individuals were determined and the correlation between hepatic fibrosis and immuno-virological status established. Statistical analysis was done using Microsoft Excel 2016 and EpiInfo7 software.Results: A high proportion (63.6%) of HIV/HCV co-infected participants had an abnormal AST level: 73.6±45.8 IU/L as compared to 58.5±39.3 IU/L (59.3%) among HCV mono-infected participants. The frequency of thrombocytopenia was 63.6% with a mean platelet count of 137±50x103 IU/L in HIV/HCV co-infected participants as compared to 176±67x103 IU/L in HCV mono-infected participants (38.4%). The progression of hepatic fibrosis in participants with clinically significant fibrosis: F2, F3 and F4 was higher among HIV/HCV co-infected and the mean APRI score was 1.7±1.4 versus 1±0.8 among HCV mono-infected (26.7%). All participants (100%) with detectable HIV viral load had clinically significant fibrosis compared to 33.4% in those with undetectable HIV viral load (p=0.55). Only 42.9% participants with CD4>500 cells/µL had clinically significant fibrosis (p=0.72) while 100% participants with CD4<200 cells/µL had clinically significant fibrosis (p=0.58). Conclusions: A high level of AST combined with thrombocytopenia (APRI score>1.5) is an indicator of hepatic fibrosis in HIV/HCV co-infected individuals. Because of its non-invasive and less costly nature, the APRI score can be a suitable biomarker to monitor hepatic fibrosis in HIV/HCV co-infected individuals in resource constrained settings.

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Thrombocytopenia according to Antiretroviral Drug Combinations, Viremia and CD4 Lymphocytes among HIV-Infected Patients in Cameroon A Snapshot from the City of Yaoundé

Cited by 6 publications

References 10 publications

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

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

Evaluation of hepatic fibrosis in HIV/HCV co-infected individuals in Yaoundé, Cameroon: usefulness of APRI score in resource-constrained settings

Evaluation of hepatic fibrosis in HIV/HCV Co-infected individuals in Yaoundé, Cameroon: Usefulness of APRI score in resource-constrained settings

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