Assessment of Immuno-Hematological changes among HIV and TB/HIV co-infected patients taking Highly Active Antiretroviral Therapy for at least six months in Menelik II Referral Hospital, Addis Ababa, Ethiopia.
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Date
2020-06
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Addis Abeba University
Abstract
Background: Cytopenias are one of the most common complications in HIV and TB/HIV coinfected
patients. Assessing immuno-hematological outcome is very essential for the management
and care of people living with HIV and TB/HIV co-infection.
Objective: To determine the Immuno-Hematological changes among HIV and TB/HIV co-infected
patients taking HAART for at least six months at Menelik II Referral Hospital.
Methods: This cross-sectional study was conducted on 338 HIV infected patients who have been
taking HAART for at least six months. Socio-demographic, clinical, CD4+ T cells and
hematological data at baseline and after at least 6 months on HAART were extracted from February
to March 2019. Student t-test was used to compute the difference between baseline and current
hematological and CD4+ T cells values. SPSS version 20 was used for data entry and analysis.
P<0.05 was considered as statistically significant.
Results: Of the total 338 individuals, 255 (75.4%) were infected with HIV only and 83 (24.6%)
were TB/HIV co-infected. There was significant increase (p<0.05) in the mean CD4 (164.6 vs 317.1
cells/l), WBC (5.89 vs 6.49×10
3
/l), Hgb (13.07 vs 13.76g/dl), platelets (245 vs 265×10
/l),
MCV (89.92 vs 96.13fl), MCH (30.25 vs 32.69pg) and a decrease in RBC (4.35 vs 4.25×10
/l)
after six months of HAART. Compared to baseline, there was also significant decrease in the rate of
Immunosuppression (CD4<350; 98.5 vs 88.5), anemia (39.9 vs 14.5%), leucopenia (22.2 vs 17.8%),
neutropenia (11.5 vs 9.2%) and thrombocytopenia (16.9 vs 9.8%) after 6 months of HAART. When
data was analyzed for HIV/TB co-infected patients separately, the effect of TB co-infection on
HAART outcome was evident. The respective baseline and current values in this group were: CD4,
149.58 vs 294.72, WBC 5.83 vs 6.62, Hgb 12.25 vs 12.91, PLT 264.1 vs 262.9, RBC 4.22 vs 4.14,
MCV 89.5 vs 92.6, MCH 29.54 vs 31.17 (P<0.05 for WBC, PLT, CD4, MCV). Rates of
Immunosuppression was 98.8 vs 92.8%, anemia 51.8 vs 39.8%, leucopenia 21.7 vs 18.1%,
neutropenia 10.8 vs 12.1%, thrombocytopenia 14.5 vs 12.0%. Besides, patients taking AZT based
drugs had significantly higher MCV and MCH values (P<0.01) than those who did not.
Conclusion: It is evident from this study that has shown significant improvements in immunohematological
profiles
after
taking
HAART for at least 6 months. The changes were more affected
with TB co-infection suggesting further investigation considering HAART adherence.
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Description
Keywords
HAART, AZT, TB/HIV co-infection, CD4 T cells, Anemia, Thrombocytopenia, Leucopenia, Neutropenia.