Prevalence and associated factors of thrombocytopenia among HAART naive HIV positive patients at Gondar university hospital, northwest Ethiopia

BMC Research Notes

Getachew Ferede¹  Dagnachew Muluye¹  Yitayih Wondimeneh¹ 

[1] School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia

关键词: CD4 count;    HAART naive;    HIV;    Thrombocytopenia;   

Others  :  1134992
DOI  :  10.1186/1756-0500-7-5

 received in 2013-07-15, accepted in 2014-01-02,  发布年份 2014

【 摘 要 】

Background

Hematological abnormalities are common in HIV positive patients. Of these, thrombocytopenia is a known complication which has been associated with progression of disease. However, its magnitude and associated factors in HAART naive HIV positive patients is not known in Ethiopia. Therefore, the aim of this study was to determine the prevalence and associated factors of thrombocytopenia in HAART naïve HIV positive patients.

Methods

A retrospective study was carried out among HAART naive HIV positive patients at Gondar University Hospital, Northwest Ethiopia, from September 2011 through August 2012. Socio-demographic variables and immunohematological (platelets and CD4+ T cells) values were carefully reviewed from medical records. Associated factors and outcomes were assessed using logistic regression.

Results

A total of 390 HAART naive HIV positive patients with a mean age of 33.65 years and a range of 18–70 years were reviewed. The overall prevalence of thrombocytopenia was 23(5.9%). The mean CD4 count was 288 ± 188.2 cells/μL. HIV patients whose age ≥ 50 years old were 2.5 times more likely to have thrombocytopenia and those patients whose CD4 count < 350 were 2.6 times more likely to have thrombocytopenia than HIV patients whose CD4 count ≥500. However, CD₄ count was not statistically associated with prevalence of thrombocytopenia (P > 0.05).

Conclusion

As CD4 counts of HIV patients decreasing, they have more likely to have thrombocytopenia. Therefore, early diagnosis and treatment of thrombocytopenia in these patients are necessary.

【 授权许可】

   
2014 Wondimeneh et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Levy JA: HIV pathogenesis, 25 years of progress and persistent challenges. AIDS 2009, 23:147-160.
• [2]Borderi M, Gibellini D, Vescini F, Crignis De Cimatti E, Biagetti L, Tampellini C: Metabolic bone disease in HIV infection. AIDS 2009, 23:1297-1310.
• [3]Gandhi RT, Sax PE, Grinspoon SK: Metabolic and cardiovascular complications in HIV-infected patients: new challenges for a new age. J Infect Dis 2012, 3:353-4.
• [4]Zon LI, Arkin C, Groopman JE: Haematologic manifestations of the human immune deficiency virus (HIV). J Haematol 1987, 66:251-256.
• [5]Moses A, Nelson J, Bagby GC: The influence of human immunodeficiency virus-1 on hematopoiesis. Blood 1998, 91:1479-1495.
• [6]Alexaki A, Wigdahl B: HIV-1 infection of bone marrow hematopoietic progenitor cells and their role in trafficking and viral dissemination. PLoS Pathog 2008, 4:e1000215.
• [7]Ratner L: Human immunodeficiency virus-associated autoimmune thrombocytopenic purpura. Am J Med 1989, 86:194-198.
• [8]Davis BR, Zauli G: Effect of human immunodeficiency virus infection on haematopoiesis. Baillieres Clin Haematol 1995, 8:113-130.
• [9]Miguez-Burbano MJ, Jackson J, Hadrigan S: Thrombocytopenia in HIV disease: clinical relevance, physiopathology and management. Curr Med Chem Cardiovasc Hematol Agents 2005, 3:365-76.
• [10]Kirchhoff F, Silvestri G: Is Nef the elusive cause of HIV-associated hematopoietic dysfunction? J Clin Invest 2008, 118:1622-5.
• [11]Dilkshit B, Wanchu A, Sachdeva RK, et al.: Profile of hematological abnormalities of Indian HIV infected individuals. BMC Blood Disorders 2009, 9:5.
• [12]Jost J, Tauber MG, Luthy R, et al.: HIV-associated thrombocytopenia. Schweiz Med Wochenschr 1988, 118:206-212.
• [13]Pechere M, Samii K, Hirschel B: HIV related thrombocytopenia. Engl J Med 1993, 328:1785-6.
• [14]Scaradavou A: HIV-related thrombocytopenia. Blood Rev 2002, 16:73-76.
• [15]Zucker-Franklin D, Cao YZ: Megakaryocytes of human immunodeficiency virus-infected individuals express viral RNA. Proc Natl Acad Sci USA 1989, 86:5595-5599.
• [16]Zucker-Frankli D, Termin CS, Cooper MC: Structural changes in the megakaryocytes of patients infected with the human immune deficiency virus (HIV-1). Am J Pathol 1989, 134:1295-1303.
• [17]Voulgaropoulou F, Pontow SE, Ratner L: Productive infection of CD34 + −cell-derived megakaryocytes by X4 and R5 HIV-1 isolates. Virology 2000, 269:78-85.
• [18]Murphy MF, Metcalfe P, Waters AH, Carne CA, Weller IV, Linch DC, Smith A: Incidence and mechanism of neutropenia and thrombocytopenia in patients with human immunodeficiency virus infection. Br J Haematol 1987, 66:337-340.
• [19]Karpatkin S, Nardi M, Lennette ET, Byrne B, Poiesz B: Anti-human immunodeficiency virus type 1 antibody complexes on platelets of seropositive thrombocytopenic homosexuals and narcotic addicts. Proc Natl Acad Sci USA 1988, 85:9763-9767.
• [20]Volberding PA, Baker KR, Levine AM: Human immunodeficiency virus hematology. American Society of Haemotology Annual Meeting; 2003:294-312.
• [21]Sloand EM, Klein HG, Banks SM, Vareldzis B, Merritt S, Pierce P: Epidemiology of thrombocytopenia in HIV infection. Eur J Haematol 1992, 48:168-72.
• [22]Steinman RM, Granelli-Piperno A, Pope M, et al.: The interaction of immunodeficiency viruses with dendritic cells. Curr Top Microbiol Immunol 2003, 276:1-30.
• [23]World Health Organisation: Nutritional anemia: report of a WHO scientific group. Geneva, Switzerland: World Health Organisation; 1968.
• [24]Majluf-Cruz A: Changes in blood coagulation in HIV infection. Rev Invest Clin 1997, 49:51-66.
• [25]Denue BA, Gashau W, Bello HS, Kida M, Bakki B, Ajayi B: Relation between some haematological abnormalities, degree of immunosuppression and viral load in treatment-naïve HIV-infected patients. EMHJ 2013, 19:4.
• [26]Sullivan PS, Hanson DL, Chu SY, Jones JL, Ciesielski CA: Surveillance for thrombocytopenia in persons infected with HIV: results from the multistate adult and adolescent spectrum of disease project. JAIDS 1997, 14:374-379.
• [27]Suresh Venkata Satya A, Singh VP, Madhukar R, Datla Vivekananda V, Gulati AK, Shyam S: Hematological profile of HIV patients in relation to immune status - a hospital-based cohort from Varanasi, North India. Turk J Hematol 2008, 25:13-19.
• [28]Erhabor O: Some haematological parameters in human immunodeficiency virus (HIV) infected Africans: the Nigerian perspective. Niger J Med 2005, 14:33-38.
• [29]Akinsegun A, Olajumoke O, Titilope A, et al.: Hematologic abnormalities in treatment naïve HIV patients. Infectious Diseases Research and Treatment 2010, 3:45-49.
• [30]Dabis F, Ekpini ER: HIV-1/AIDS and maternal and child health in Africa. Lancet 2002, 359:2097-104.
• [31]Joint United Nations Programme on HIV/AIDS and World Health Organization: AIDS epidemic update: Dec 2004. Geneva, Switzerland: UNAIDS; 2004.
• [32]Elisaphane M, Ivan E, Eugene M, et al.: Assessment of haematological parameters in HIV-infected and uninfected Rwandan women: a cross-sectional study. BMJ Open 2012, 2:e001600.
• [33]Ira S, Bhushan K: Hematological manifestation in haart naive hiv-1 infected children in india in a resource limited setting. PIDC 2011, 8:35.