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Published in: BMC Hematology 1/2014

Open Access 01-12-2014 | Research article

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

Authors: Bamlaku Enawgaw, Meseret Alem, Zelalem Addis, Mulugeta Melku

Published in: BMC Hematology | Issue 1/2014

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Abstract

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.
Literature
1.
go back to reference 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. 10.1097/00002030-200301030-00016.CrossRefPubMed 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. 10.1097/00002030-200301030-00016.CrossRefPubMed
2.
go back to reference 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. 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.
go back to reference Dikshit B, Wanchu A, Sachdeva KR, Sharma A, Das R: Profile of hematological abnormalities of Indian HIV infected individuals. BMC Blood Disorders. 2009, 9: 5-10.1186/1471-2326-9-5.PubMedPubMedCentral Dikshit B, Wanchu A, Sachdeva KR, Sharma A, Das R: Profile of hematological abnormalities of Indian HIV infected individuals. BMC Blood Disorders. 2009, 9: 5-10.1186/1471-2326-9-5.PubMedPubMedCentral
4.
go back to reference Akinbami A, Oshinaike O, Adeyemo T: Hematologic abnormalities in treatment-naïve HIV patients. Lagos, Nigeria. Infect Dis: Res Treat. 2010, 3: 45-49. Akinbami A, Oshinaike O, Adeyemo T: Hematologic abnormalities in treatment-naïve HIV patients. Lagos, Nigeria. Infect Dis: Res Treat. 2010, 3: 45-49.
5.
go back to reference 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. 10.1089/aid.2005.21.200.CrossRefPubMed 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. 10.1089/aid.2005.21.200.CrossRefPubMed
6.
go back to reference 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. 10.1016/j.amjmed.2003.12.010.CrossRef 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. 10.1016/j.amjmed.2003.12.010.CrossRef
7.
go back to reference Patwardhan MS, Golwilkar AS, Abhyankar JR, Atre MC: Hematological profile of HIV positive patients. Indian J Pathol Microbiol. 2002, 45 (2): 147-150.PubMed Patwardhan MS, Golwilkar AS, Abhyankar JR, Atre MC: Hematological profile of HIV positive patients. Indian J Pathol Microbiol. 2002, 45 (2): 147-150.PubMed
8.
go back to reference Volberding P: The impact of anemia on quality of life in human immunodeficiency virus-infected patients. J Infect Dis. 2002, 185: 110-114. 10.1086/324772.CrossRef Volberding P: The impact of anemia on quality of life in human immunodeficiency virus-infected patients. J Infect Dis. 2002, 185: 110-114. 10.1086/324772.CrossRef
9.
go back to reference 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 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.
go back to reference 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.PubMed 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.PubMed
11.
go back to reference 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.PubMed 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.PubMed
12.
go back to reference 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: 8-10.1186/2052-1839-13-8. 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: 8-10.1186/2052-1839-13-8.
13.
go back to reference 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. 10.1258/ijsa.2008.008370.CrossRefPubMedPubMedCentral 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. 10.1258/ijsa.2008.008370.CrossRefPubMedPubMedCentral
14.
go back to reference De Santis GC, Brunetta DM, Vilar FC: Hematological abnormalities in HIV-infected patients. Int J Infect Dis. 2011, 15: e808-e11. 10.1016/j.ijid.2011.08.001.CrossRefPubMed De Santis GC, Brunetta DM, Vilar FC: Hematological abnormalities in HIV-infected patients. Int J Infect Dis. 2011, 15: e808-e11. 10.1016/j.ijid.2011.08.001.CrossRefPubMed
15.
go back to reference 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. 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.
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
17.
go back to reference 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.PubMedPubMedCentral 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.PubMedPubMedCentral
18.
go back to reference 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. 10.1185/030079906X162683.CrossRefPubMed 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. 10.1185/030079906X162683.CrossRefPubMed
19.
go back to reference 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. 10.1097/00042560-200111010-00003.CrossRefPubMed 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. 10.1097/00042560-200111010-00003.CrossRefPubMed
20.
go back to reference Bain BJ: The haematological features of HIV infection. Br J Haematol. 1997, 99: 1-8. 10.1046/j.1365-2141.1997.2943111.x.CrossRefPubMed Bain BJ: The haematological features of HIV infection. Br J Haematol. 1997, 99: 1-8. 10.1046/j.1365-2141.1997.2943111.x.CrossRefPubMed
21.
go back to reference 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.PubMed 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.PubMed
22.
go back to reference Dreyfus DH: Autoimmune disease: a role for new anti-viral therapies?. Autoimmun Rev. 2011, 11: 88-97. 10.1016/j.autrev.2011.08.005.CrossRefPubMed Dreyfus DH: Autoimmune disease: a role for new anti-viral therapies?. Autoimmun Rev. 2011, 11: 88-97. 10.1016/j.autrev.2011.08.005.CrossRefPubMed
Metadata
Title
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
Authors
Bamlaku Enawgaw
Meseret Alem
Zelalem Addis
Mulugeta Melku
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Hematology / Issue 1/2014
Electronic ISSN: 2052-1839
DOI
https://doi.org/10.1186/2052-1839-14-8

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Reviewer acknowledgement

Reviewer acknowledgement 2013