Determination of hematological and immunological parameters among HIV positive patients taking highly active antiretroviral treatment and treatment naïve in the antiretroviral therapy clinic of Gondar University Hospital, Gondar, Northwest Ethiopia: a comparative cross-sectional study

BMC Hematology

Mulugeta Melku¹  Zelalem Addis³  Meseret Alem²  Bamlaku Enawgaw¹ 

[1] Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia;Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia;Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

关键词: HAART;    Thrombocytopenia;    Leucopenia;    Anemia;    HIV;   

Others  :  863118
DOI  :  10.1186/2052-1839-14-8

 received in 2013-07-14, accepted in 2014-03-19,  发布年份 2014

【 摘 要 】

Background

Anemia, leucopenia and thrombocytopenia are the commonest hematological abnormalities resulting from human immunodeficiency virus infection. The use of antiretroviral drugs could positively or negatively affect these disorders. Thus a specific diagnosis and a determination of hematological and immunological parameters are required for initiating and monitoring early treatment to avert disease progression. Therefore, this study aimed to compare hematological and immunological parameters in HIV positive patients taking antiretroviral therapy and those treatment naïve patients in Gondar University Hospital.

Methods

A comparative cross-sectional study was conducted on a total of 290 HIV patients from February to May 2012 in Gondar University Hospital. Study subjects were divided in to two groups: 145 HIV positive treatment naïve and 145 on HAART. Data of socio demographic characteristics and clinical conditions of the study subjects was collected using structured pretested questionnaire at their follow up date. Hematological and immunological parameters were collected and processed by cell Dyne 1800 and BD FACS count respectively. The variables compared here were Hematological parameters (Total and differential WBC, RBC, Hgb, HCT, MCV, MCH, MCHC, RDW, PLT, and MPV) and CD4 count. In order to compare means independent sample T-test was conducted using SPSS version 20 statistical software. P- Value < 0.05 was considered as significant.

Result

Prevalence of anemia, leucopenia, thrombocytopenia, neutropenia and lymphopenia were 11.7%, 35.9%, 4.1%, 28.3% and 2.1% in patients on HAART and 29.7%, 16.6%, 9%, 14.5% and 2.1% in HAART naïve patients respectively. There was a significant difference in total WBC, RBC, Hgb, MCV, MCH, MCHC, MPV and CD4 counts between patients on HAART and HAART naïve patients.

Conclusion

Prevalence of anemia was high in HAART naïve patients while leucopenia and neutropenia prevalence was higher in patients on HAART and their prevalence increased as the CD4 count decreased. HIV Patients should be investigated for hematological and immunological changes following with appropriate therapeutic interventions.

【 授权许可】

   
2014 Enawgaw et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Gange SJ, Lau B, Phair J, Riddler SA, Detels R, Margolick JB: Rapid declines in total lymphocyte count and hemoglobin in HIV infection begin at CD4 lymphocyte counts that justify antiretroviral therapy. AIDS 2003, 17:119-121.
• [2]Muluneh A, Fessahaye A: Hematologic abnormalities among children on HAART in Jimma University Specialized Hospital, Southwestern Ethiopia. Ethiop J Health Sci 2009, 19(2):83-89.
• [3]Dikshit B, Wanchu A, Sachdeva KR, Sharma A, Das R: Profile of hematological abnormalities of Indian HIV infected individuals. BMC Blood Disorders 2009, 9:5. BioMed Central Full Text
• [4]Akinbami A, Oshinaike O, Adeyemo T: Hematologic abnormalities in treatment-naïve HIV patients. Lagos, Nigeria. Infect Dis: Res Treat 2010, 3:45-49.
• [5]Behler C, Shade S, Gregory K, Abrams D, Volberding P: Anemia and HIV in the antiretroviral era: potential significance of testosterone. AIDS Res Hum Retrovir 2005, 21(3):200-206.
• [6]Belperio PS, Rhew DC: Prevalence and outcomes of anemia in individuals with human immunodeficiency virus: a systematic review of the literature. Am J Med 2004, 116(7):27-43.
• [7]Patwardhan MS, Golwilkar AS, Abhyankar JR, Atre MC: Hematological profile of HIV positive patients. Indian J Pathol Microbiol 2002, 45(2):147-150.
• [8]Volberding P: The impact of anemia on quality of life in human immunodeficiency virus-infected patients. J Infect Dis 2002, 185:110-114.
• [9]Liebman HA: Viral-associated immune thrombocytopenic purpura. Hematology the Education Program of the American Society of Hematology. American Society of Hematology. Education Program 2008, 212-218. Epub 2008/12/17
• [10]Kouri YH, Borkowsky W, Nardi M, Karpatkin S, Basch RS: Human megakaryocytes have a CD4 molecule capable of binding human immunodeficiency virus-1. Blood 1993, 81(10):2664-2670.
• [11]Adane A, Desta K, Bezabih A, Gashaye A, Kassa D: HIV-associated anaemia before and after initiation of antiretroviral therapy at ART Centre of Minilik II Hospital, Addis Ababa, Ethiopia. Ethiop Med J 2012, 50(1):13-21.
• [12]Ferede G, Wondimeneh Y: Prevalence and related factors of anemia in HAART-naive HIV positive patients at Gondar University Hospital, Northwest Ethiopia. BMC Hematology 2013, 13:8. BioMed Central Full Text
• [13]Subbaraman R, Devaleenal B, Selvamuthu P: Factors associated with anaemia in HIV-infected individuals in southern India. Int J STD AIDS 2009, 20(7):489-492.
• [14]De Santis GC, Brunetta DM, Vilar FC: Hematological abnormalities in HIV-infected patients. Int J Infect Dis 2011, 15:e808-e11.
• [15]Amballi AA, Ajibola A, Ogun SA: Demographic pattern and haematological profile in people living with HIV in a university teaching hospital. Sci Res Essay 2007, 2(8):315-318.
• [16]Erhabor O, Ejele OA, Nwauche CA, Buseri FI: Some haematological parameters in human immunodeficiency virus (HIV) infected Africans: the Nigerian perspective. Niger J Med 2005, 14(1):33-38.
• [17]Owiredu W, Quaye L, Amidu N, Addai-Mensah O: Prevalence of anaemia and immunological markers among Ghanaian HAART-naïve HIV-patients and those on HAART. Afr Health Sci 2011, 11(1):2-15.
• [18]Mildvan D, Creagh T, Leitz G: Prevalence of anemia and correlation with biomarkers and specific antiretroviral regimens in 9690 human-immunodeficiency-virus-infected patients: findings of the anemia prevalence study. Curr Med Res Opin 2007, 23(2):343-355.
• [19]Servais J, Nkoghe D, Schmit JC, Arendt V, Robert I, Staub T, Moutschen M, Schneider F, Hemmer R: HIV-associated hematologic disorders are correlated with plasma viral load and improve under highly active antiretroviral therapy. J Acquir Immune Defic Syndr 2001, 28(3):221-225.
• [20]Bain BJ: The haematological features of HIV infection. Br J Haematol 1997, 99:1-8.
• [21]Adediran IA, Durosinmi MA: Peripheral blood and bone marrow changes in patients with acquired immunodeficiency syndrome. Afr J Med Med Sci 2006, 35:85-91.
• [22]Dreyfus DH: Autoimmune disease: a role for new anti-viral therapies? Autoimmun Rev 2011, 11:88-97.