Abstract
Introduction: Disorders of hematopoietic system including anemia, leucopenia and thrombocytopenia are common throughout the course of HIV infection. Anemia is common in patients with HIV infection, particularly those with advanced disease. Anemia is associated with quality of life decrements, decreased survival and increased disease progression in adults with HIV infection. It has adversely changing patient's quality of life and hamper treatment of both the primary viral infection and the secondary infections.
Material and Methods: This is a prospective cross sectional study of 500 HIV positive patients, conducted in the Department of Pathology of Government Medical College and Hospital between the period two years. The hematological parameters were obtained by processing whole blood on Electronic Cell counter. Demographical and clinical data of the patient was also obtained. Data obtained from Electronic counter, peripheral smear examination and BD FACScan flow cytometer was put together and analyzed.
Results: Anaemia was the most common haematological abnormality observed. The overall prevalence of anaemia, neutropenia, thrombocytopenia, lymphopenia, leucopenia, pancytopenia and eosinophilia was 70%, 3.4%, 3.4%, 7.6%, 5.6%, 4.0% and 9.8% respectively. The prevalence of anemia and other hematological abnormalities were higher in patients with advanced disease, CD4 count <200/ µl. ART was associated with lower prevalence of anemia
Conclusion: Prevalence of haematological abnormalities in HIV positive patients is significantly high even in this HAART era. Anemia is the most common hematological abnormality in HIV seropositive patients and its incidence is strongly associated with the progression of the disease. ART is associated with reduced prevalence of Anaemia and has therapeutic and preventive implications.
Keywords: Anaemia, ART, HIV, AIDS, HAART.
References
- Moore RD, Keruly JC, Chaisson RE. Anemia and survival in HIV infection. J Acquir Immune Defic Syndr Hum Retrovirol1998; 19(1):29-33.
- Patwardhan MS, Golwilkar AS, Abhyankar JR, Atre MC. Hematological profile of HIV positive patients. Indian J Pathol Microbiol 2002; 45:147-150.
- Amballi A1,Ajibola A2,Ogun, S. A.3, Ogunkolo, O. F.2, Salu, L. O.4, and Oritogun, K. S.4 and Oyegunle, V. A.1 Demographic pattern and haematological profile in people living with HIV/AIDS in a university teaching hospital. Scientific Research and Essay Vol. 2 (8), pp. 315-318, August 2007.
- Dikshit B, Wanchu A, Sachdeva RK, Sharma A, Das R. Profile of hematological abnormalities of Indian HIV infected individuals. BMC Blood Disorders 2009; 9:5-10.
- Attili SVS, Singh VP, Rai M, Varma DV, Gulati AK, Sundar 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.
- Sullivan PS, Hanson DL, Chu SY, et al: Epidemiology of anemia in human immunodeficiency virus infected persons: Results from the Multistate Adult and Adolescent Spectrum of HIV Disease Surveillance Project. Blood 1998;91:301-8
- Lewis SM. Reference ranges and normal values. In: Lewis SM, Bain BJ, Bates I, eds. Dacie and Lewis Practical Haemato-logy. 10 th ed. Churchill Livingstone, Elsevier Ltd,Philadelphia Inc. 2006; 11-24.
- Omoregie R, Omokaro EU, Palmer O, Ogefere HO, Egbeobauwaye A, et al Prevalence of anaemia among HIV-infected patients in Benin City, Nigeria. Tanzania Journal of Health Research 2009; 11: 1-4.
- Greer JP,Foerster JF, Lukens JN, Rodgers GM, Paraskevas F, Glader B eds. Wintrobe’s Clinical Hematology. 11 th ed. Lippincott Williams & Wilkins. 2004; 1777-1800
- Berhane K, Karim R, Cohen MH: Impact of highly active antiretroviral therapy on anemia and relationship between anemia and survival in a large cohort of HIV-infected women: Women's Interagency HIV Study. J Acquir Immune Defic Syndr 2004; 37:1245-1252.
- Mocroft A, Kirk O, Barton SE, et al: Anaemia is an independent predictive marker for clinical prognosis in HIV infected patients from across Europe. AIDS 1999; 13:943-50.
- Amegor OF, Bigilia DA, Oyesola OA, Oyesola TO, Buseni ST. Hematological changes in HIV patients placed on Anti Retroviral Therapy in Markurdi, Benue State of Nigeria. Asian J. Epidemiol. 2009; 2: 97-103.
- Huang SS, Barbour JD, Deeks SG, Huang JS, Grant RM, et al: Reversal of human immunodeficiency virus type 1 associated hematosuppression by effective antiretro-viral therapy. Clin Infect Dis 2000; 30:504-10.
- Semba RD, Shah N, Vlahov D. Improvement of Anemia Among HIV-Infected Injection Drug Users Receiving Highly Active Antiretroviral Therapy. JAIDS 2001;26:315–19.
- Kreuzer KA, Rockstroh JK, Jelkmann W, et al. Inadequate erythropoietin response to anaemia in HIV patients: relationship to serum levels of tumour necrosis factor-alpha, interleukin-6 and their soluble receptors. Br J Haematol 1997;96:235–39.
- Murphy M, Perussia B, Trinchieri G. Effects of recombinant tumor necrosis factor, lymphotoxin, and immune interferon on proliferation and differenti-ation of enriched hematopoietic precursor cells. Exp Hematol 1988;16:131–38.
- Amirayan-Chevillard N, Tissot-Dupont H, Capo C, et al. Impact of highly active anti-retroviral therapy (HAART) on cytokine production and monocyte subsets in HIV-infected patients. Clin Exp Immunol 2000;120:107–12.
- Bini EJ, Cohen J. Impact of protease inhibitors on the outcome of human immunodeficiency virus-infected patients with chronic diarrhea. Am J Gastroenterol 1999;94:3553–59.
- Maggi P, Larocca AM, Quarto M, Serio G, Brandonisio O, et al. Effect of antiretroviral therapy on cryptosporidiosis and microsporidiosis in patients infected with human immunodeficiency virus type 1. Eur J Clin Microbiol Infect Dis 2000; 19:213–7.
- Semba RD, Tang AM. Micronutrients and the pathogenesis of human immunodef-iciency virus infection. Br J Nutr 1999;81: 181–9.
- Tang AM, Smit E, Semba RD, Shah N, Lyles CM, et al. Improved antioxidant status among HIV-infected injecting drug users on potent antiretroviral therapy. J Acquir Immune Defic Syndr 2000;23:321–6.
- Mylonakis E, Dickinson BP, Mileno MD, Flanigan T, Schiffman. FJ, et al. Persistent parvovirus B19 related anemia of seven years’ duration in an HIVinfected patient: complete remission associated with highly active antiretroviral therapy. Am J Hematol 1999;60:164–6.
- Scapellato PG, Palumbo AM, Del Valle S. Improvement of anemia by parvovirus B19 in a patient with AIDS after combined antiretroviral therapy [letter]. Mayo Clin Proc 2000;75:215–6.
- Maschke M, Kastrup O, Esser S, RossB, Henge U, et al. Incidence and prevalence of neurological disorders associated with HIV since the introduction of highly active antiretroviral therapy (HAART). J Neurol Neurosurg Psychiatry 2000;69:376–80.
- Pluda JM, Mitsuya H, Yarchoan R. Hematologic effects of AIDS therapies. Hemat Oncol Clin North Am 1991;5:229–48.
- Sloand EM, Maciejewski J, Kumar P, Kim S, Chaudhuri A, et al. Protease inhibitors stimulate hematopoiesis and decrease apoptosis and ICE expression in CD34+ cells. Blood 2000;96:2735–39.
Corresponding Author
Dr Amitkumar Bapuso Pandav
Associate Professor, Department of Pathology,
Government Medical College, Miraj 416410
Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Mobile no- 9881979069
DOI: https://dx.doi.org/10.18535/jmscr/v6i1.87
