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Published in: BMC Hematology 1/2014

Open Access 01-12-2014 | Research article

Profile of blood cell abnormalities among antiretroviral therapy naïve HIV patients attending the Yaounde University Teaching Hospital, Cameroon

Authors: Paul Nji Wankah, Claude Tayou Tagny, Dora Ngum Shu Mbanya

Published in: BMC Hematology | Issue 1/2014

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Abstract

Background

Abnormal hemograms are common manifestations and important predictive tools for morbidity in the human immunodeficiency virus (HIV) infection. Few studies have been reported on the blood profile of HIV antiretroviral therapy (ART) naive subjects, therefore this study aimed to quantitatively and qualitatively describe the blood cell profile of HIV ART naive patients, and to describe the occurrence of the blood cytopenias by CD4 cell counts and WHO clinical stage.

Methods

This cross-sectional study of ART naive HIV patients was done at the Yaounde University Teaching Hospital (YUTH). For eligible participants, a structured questionnaire was filled and a clinical examination was done. Blood samples were collected for the measurement of full blood count and CD4 cell count. Blood films were made for the cytological examination of the blood samples and a reticulocyte count was done by the cresyl blue stain method.

Results

Of 81 cases reviewed, 66 (81.5%) had a blood cell disorder. The main qualitative blood disorders on the blood film were metamyelocytes (37.1%), toxic neutrophils (33.3%), stab neutrophils (29.6%), anisocytosis (35.6%) hypochromia (32.1%) and giant platelets (22.2%). Anaemia (62.9%) was the most common quantitative disorder of which 86.3% had low reticulocyte counts. Participants with low CD4 counts and advanced clinical stages had a greater occurrence of blood cytopenias (p-values <0.05).

Conclusion

In the HIV infection, peripheral blood cell abnormalities affect all cell lineages, with anaemia being the most frequent single blood cell abnormality. Blood cytopenias mainly occur in advanced immunosuppression and clinical stages. Although all HIV patients may have blood cell disorders, those with advanced disease are more prone to develop them.
Literature
1.
go back to reference Anastos K, Shi Q, French AL, Levine A, Greenblatt RM, Williams C, DeHowitz J, Delapenha R, Hoover DR: Total lymphocyte count, hemoglobin and delayed-type hypersensitivity as predictors of death and AIDS illness in HIV-1 infected women receiving highly active antiretroviral therapy. J Acquir Immune Defic Syndr. 2004, 35: 383-392. 10.1097/00126334-200404010-00008.CrossRefPubMed Anastos K, Shi Q, French AL, Levine A, Greenblatt RM, Williams C, DeHowitz J, Delapenha R, Hoover DR: Total lymphocyte count, hemoglobin and delayed-type hypersensitivity as predictors of death and AIDS illness in HIV-1 infected women receiving highly active antiretroviral therapy. J Acquir Immune Defic Syndr. 2004, 35: 383-392. 10.1097/00126334-200404010-00008.CrossRefPubMed
2.
go back to reference Ajayi AO, Ajayi EA, Fasakin KA: CD4+ T-lymphocytes cell counts in adults with human immunodeficiency virus infection at the medical department of a tertiary health institution in Nigeria. Ann Afr Med. 2009, 8: 257-260. 10.4103/1596-3519.59581.CrossRefPubMed Ajayi AO, Ajayi EA, Fasakin KA: CD4+ T-lymphocytes cell counts in adults with human immunodeficiency virus infection at the medical department of a tertiary health institution in Nigeria. Ann Afr Med. 2009, 8: 257-260. 10.4103/1596-3519.59581.CrossRefPubMed
3.
go back to reference Coyle TE: Hematologic complications of human immunodeficiency virus infection and the acquired immunodeficiency syndrome. Med Clin North Am. 1997, 81: 449-470. 10.1016/S0025-7125(05)70526-5.CrossRefPubMed Coyle TE: Hematologic complications of human immunodeficiency virus infection and the acquired immunodeficiency syndrome. Med Clin North Am. 1997, 81: 449-470. 10.1016/S0025-7125(05)70526-5.CrossRefPubMed
4.
go back to reference Akinbami A, Oshinaike O, Adeyemo T, Adediran A, Dosunmu O, Dada M, Durojaiye I, Adebola A, Oshunkalu V: Hematologic Abnormalities in Treatment-Naïve HIV Patients. Infect Dis Res Treat. 2010, 3: 45-49. Akinbami A, Oshinaike O, Adeyemo T, Adediran A, Dosunmu O, Dada M, Durojaiye I, Adebola A, Oshunkalu V: Hematologic Abnormalities in Treatment-Naïve HIV Patients. Infect Dis Res Treat. 2010, 3: 45-49.
5.
go back to reference Obirikorang C, Yeboah FA: Blood hemoglobin measurements as a predictive indicator for the progression of HIV/AIDS in resource-limited setting. J Biomed Sci. 2009, 16: 102-10.1186/1423-0127-16-102.CrossRefPubMedPubMedCentral Obirikorang C, Yeboah FA: Blood hemoglobin measurements as a predictive indicator for the progression of HIV/AIDS in resource-limited setting. J Biomed Sci. 2009, 16: 102-10.1186/1423-0127-16-102.CrossRefPubMedPubMedCentral
6.
go back to reference Aboulafia DM, Mitsuyasu RT: Hematologic abnormalities in AIDS. Hematol Oncol Clin North Am. 1991, 5: 195-PubMed Aboulafia DM, Mitsuyasu RT: Hematologic abnormalities in AIDS. Hematol Oncol Clin North Am. 1991, 5: 195-PubMed
7.
go back to reference Kreuzer KA, Rockstroh JK: Pathogenesis and pathophysiology of anaemia in HIV infection. Ann Hematol. 1997, 75: 179-187. 10.1007/s002770050340.CrossRefPubMed Kreuzer KA, Rockstroh JK: Pathogenesis and pathophysiology of anaemia in HIV infection. Ann Hematol. 1997, 75: 179-187. 10.1007/s002770050340.CrossRefPubMed
8.
go back to reference Jost J, Tauber MG, Luthy R, Siegenthaler W: HIV-associated thrombocytopenia. Schweiz Med Wochenschr. 1988, 118: 206-212.PubMed Jost J, Tauber MG, Luthy R, Siegenthaler W: HIV-associated thrombocytopenia. Schweiz Med Wochenschr. 1988, 118: 206-212.PubMed
9.
go back to reference Salond E: Hematologic complications of HIV infection. AIDS Rev. 2005, 7: 187-196. Salond E: Hematologic complications of HIV infection. AIDS Rev. 2005, 7: 187-196.
10.
go back to reference Cosby CD: Hematologic disorders associated with human immunodeficiency virus and AIDS. J Infus Nurs. 2007, 30: 22-32. 10.1097/00129804-200701000-00005.CrossRefPubMed Cosby CD: Hematologic disorders associated with human immunodeficiency virus and AIDS. J Infus Nurs. 2007, 30: 22-32. 10.1097/00129804-200701000-00005.CrossRefPubMed
11.
go back to reference Mata-Marín JA, Gaytán-Martínez JE, Martínez-Martín RE, Arroyo-Anduiza CI, Fuentes-Allen JL, Casarrubias-Ramirez M: Risk factors and correlates for anaemia in HIV treatment-naïve infected patients: a cross-sectional analytical study. BMC Res Notes. 2010, 3: 230-10.1186/1756-0500-3-230.CrossRefPubMedPubMedCentral Mata-Marín JA, Gaytán-Martínez JE, Martínez-Martín RE, Arroyo-Anduiza CI, Fuentes-Allen JL, Casarrubias-Ramirez M: Risk factors and correlates for anaemia in HIV treatment-naïve infected patients: a cross-sectional analytical study. BMC Res Notes. 2010, 3: 230-10.1186/1756-0500-3-230.CrossRefPubMedPubMedCentral
12.
go back to reference Rudnicka D, Schwartz O: Intrusive HIV-1-infected cells. Nat Immunol. 2009, 10: 933-934. 10.1038/ni0909-933.CrossRefPubMed Rudnicka D, Schwartz O: Intrusive HIV-1-infected cells. Nat Immunol. 2009, 10: 933-934. 10.1038/ni0909-933.CrossRefPubMed
13.
go back to reference Mocroft A, Kirk O, Barton SE, Dietrich M, Proenca R, Colebunders R, Pradier C, DArminio Monforte A, Ledergerber B, Lundgren JD: Anaemia is an independent predictive marker for clinical prognosis in HIV-infected patients from across Europe. EuroSIDA study group. AIDS. 1999, 13 (8): 943-950. 10.1097/00002030-199905280-00010.CrossRefPubMed Mocroft A, Kirk O, Barton SE, Dietrich M, Proenca R, Colebunders R, Pradier C, DArminio Monforte A, Ledergerber B, Lundgren JD: Anaemia is an independent predictive marker for clinical prognosis in HIV-infected patients from across Europe. EuroSIDA study group. AIDS. 1999, 13 (8): 943-950. 10.1097/00002030-199905280-00010.CrossRefPubMed
14.
go back to reference May M, Boulle A, Phiri S, Messou E, Myer L, Wood R, Keiser O, Sterne JA, Dabis F, Egger M: Prognosis of patients with HIV-1 infection starting antiretroviral therapy in sub-Saharan Africa: a collaborative analysis of scale-up programmes. Lancet. 2010, 376 (9739): 449-457. 10.1016/S0140-6736(10)60666-6.CrossRefPubMedPubMedCentral May M, Boulle A, Phiri S, Messou E, Myer L, Wood R, Keiser O, Sterne JA, Dabis F, Egger M: Prognosis of patients with HIV-1 infection starting antiretroviral therapy in sub-Saharan Africa: a collaborative analysis of scale-up programmes. Lancet. 2010, 376 (9739): 449-457. 10.1016/S0140-6736(10)60666-6.CrossRefPubMedPubMedCentral
15.
go back to reference Giganti MJ, Limbada M, Mwango A, Moyo C, Mulenga LB, Guffey MB, Mulenga PL, Bolton-Moore C, Stringer JSA, Chi BH: Six-month hemoglobin concentration and its association with subsequent mortality among adults on antiretroviral therapy in Lusaka, Zambia. J Acquir Immune Defic Syndr. 2012, 61 (1): 120-123. 10.1097/QAI.0b013e31825da11d.CrossRefPubMedPubMedCentral Giganti MJ, Limbada M, Mwango A, Moyo C, Mulenga LB, Guffey MB, Mulenga PL, Bolton-Moore C, Stringer JSA, Chi BH: Six-month hemoglobin concentration and its association with subsequent mortality among adults on antiretroviral therapy in Lusaka, Zambia. J Acquir Immune Defic Syndr. 2012, 61 (1): 120-123. 10.1097/QAI.0b013e31825da11d.CrossRefPubMedPubMedCentral
16.
go back to reference Mbanya DNS, Tsafack JP, Binam F, Afane Ze E, Kaptue LN: Peripheral blood cell changes in AIDS patients in Yaoundé, Cameroon. Bull Liais Doc OCEAC. 2001, 34 (4): 14-17. Mbanya DNS, Tsafack JP, Binam F, Afane Ze E, Kaptue LN: Peripheral blood cell changes in AIDS patients in Yaoundé, Cameroon. Bull Liais Doc OCEAC. 2001, 34 (4): 14-17.
18.
go back to reference Harald T, Heinz D, Torsten H: Atlas de poche d'hematologie. Edited by: LAVOISIER MSP. 2009, Paris: Flammarion, 11-2 Harald T, Heinz D, Torsten H: Atlas de poche d'hematologie. Edited by: LAVOISIER MSP. 2009, Paris: Flammarion, 11-2
19.
go back to reference Fry TJ, Connick E, Falloon J, Lederman MM, Liewehr DJ, Spritzler J, Steinberg SM, Wood LV, Yarchoan R, Zuckerman J, Landay A, Mackall CL: A potential role for interleukin-7 in T-cell homeostasis. Blood. 2001, 97: 2983-2990. 10.1182/blood.V97.10.2983.CrossRefPubMed Fry TJ, Connick E, Falloon J, Lederman MM, Liewehr DJ, Spritzler J, Steinberg SM, Wood LV, Yarchoan R, Zuckerman J, Landay A, Mackall CL: A potential role for interleukin-7 in T-cell homeostasis. Blood. 2001, 97: 2983-2990. 10.1182/blood.V97.10.2983.CrossRefPubMed
20.
go back to reference WHO: Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Vitamin and Mineral Nutrition Information System. WHO/NMH/NHD/MNM/11.1. 2011, Geneva: World Health Organisation WHO: Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Vitamin and Mineral Nutrition Information System. WHO/NMH/NHD/MNM/11.1. 2011, Geneva: World Health Organisation
21.
go back to reference Kasper DL, Braunwald E, Fauci A, Hauser S, Longo D, Jameson LJ: Harrison's Principles of Internal Medicine, Volume 1. 2005, USA: McGraw-Hill Professional, 16 Kasper DL, Braunwald E, Fauci A, Hauser S, Longo D, Jameson LJ: Harrison's Principles of Internal Medicine, Volume 1. 2005, USA: McGraw-Hill Professional, 16
22.
go back to reference 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.PubMed 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.PubMed
23.
go back to reference Mugisha JO, Shafer LA, van der Paal L, Mayanja BN, Eotu H, Hugues P, Whitworth JA, Grosskurth H: Anaemia in rural Uganda HIV cohort, prevalence at enrolment, incidence, diagnosis and associated factors. Trop Med Int Health. 2008, 13 (6): 788-794. 10.1111/j.1365-3156.2008.02069.x.CrossRefPubMed Mugisha JO, Shafer LA, van der Paal L, Mayanja BN, Eotu H, Hugues P, Whitworth JA, Grosskurth H: Anaemia in rural Uganda HIV cohort, prevalence at enrolment, incidence, diagnosis and associated factors. Trop Med Int Health. 2008, 13 (6): 788-794. 10.1111/j.1365-3156.2008.02069.x.CrossRefPubMed
24.
go back to reference Zon LI, Groopman JE: Hematologic manifestations of the Human Immunodeficiency Virus (HIV). Semin Hematol. 1988, 25: 208-218.PubMed Zon LI, Groopman JE: Hematologic manifestations of the Human Immunodeficiency Virus (HIV). Semin Hematol. 1988, 25: 208-218.PubMed
25.
go back to reference Spivak JL, Barnes DC, Fuchs E, Quinn TC: Serum immunoreactive erythropoietin in HIV-infected patients. JAMA. 1989, 261 (21): 3104-3107. 10.1001/jama.1989.03420210052015.CrossRefPubMed Spivak JL, Barnes DC, Fuchs E, Quinn TC: Serum immunoreactive erythropoietin in HIV-infected patients. JAMA. 1989, 261 (21): 3104-3107. 10.1001/jama.1989.03420210052015.CrossRefPubMed
26.
go back to reference Kaslow RA, Phair JP, Friedman HB: Infection with the human immunodeficiency virus: Clinical manifestations and their relationship to immune deficiency. A report from the Multicenter AIDS Cohort Study. Ann Intern Med. 1987, 107: 478-480.CrossRef Kaslow RA, Phair JP, Friedman HB: Infection with the human immunodeficiency virus: Clinical manifestations and their relationship to immune deficiency. A report from the Multicenter AIDS Cohort Study. Ann Intern Med. 1987, 107: 478-480.CrossRef
27.
go back to reference Phillips RE, Pasvol G: Anaemia of Plasmodium falciparum malaria. Epidemioogy of Haematological disease: Part II. Baillier's Clinical Hematology, Volume 5. 1992, London: Fleming AF, 315-330. Phillips RE, Pasvol G: Anaemia of Plasmodium falciparum malaria. Epidemioogy of Haematological disease: Part II. Baillier's Clinical Hematology, Volume 5. 1992, London: Fleming AF, 315-330.
Metadata
Title
Profile of blood cell abnormalities among antiretroviral therapy naïve HIV patients attending the Yaounde University Teaching Hospital, Cameroon
Authors
Paul Nji Wankah
Claude Tayou Tagny
Dora Ngum Shu Mbanya
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Hematology / Issue 1/2014
Electronic ISSN: 2052-1839
DOI
https://doi.org/10.1186/2052-1839-14-15

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