Changes in hematological parameters in HIV-1 infected patients before and after antiretroviral therapy in Tikur Anbessa Specialized Teaching Hospital ART clinic.
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Date
2011-11
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Addis Ababa University
Abstract
HIV/AIDS is characterized by progressive damage to the body’s immune system that results in a
number of opportunistic infections, immunological and hematological complications.
Hematological complications have been documented to be the second most common cause of
morbidity and mortality and are estimated to affect from 11% to 75% of patients with HIV
disease. They are generally marked with cytopenias such as anemia, neutropenia, lymphopenia
and thrombocytopenia. These abnormalities may be of greater concern in populations in subSahara
Africa, where comorbidities such as malnutrition, malaria, and parasitic infections are
common, and capacity to monitor adverse events related to ART is often limited. Although
treatment of HIV infected patients using ART is accepted as the gold standard, few studies tried
to assess hematologic responses to ART.
A comparative cross sectional study was conducted to determine changes in hematologic
parameters in HIV infected patients before and after ART from July to August 2011 in TASTH
ART clinic. Socio-demographic, baseline hematologic parameters and ART related information
of study participants were collected using a structured questionnaire. CBC and CD4+ T cell
count was done for 340 HIV infected patients by hematological analyzer and FACS count,
respectively. The data was entered and analyzed in simple descriptive statistical methods using
SPSS window version 16.
From this study, WBC, neutrophils, lymphocyte, hemoglobin and platelet count showed
increment from the baseline by mean 0.36 x 10
3
/ μL, 0.12 x 10
3
/ μL, 0.25 x 10
/ μL, 0.98 g/dL
and 20 x 10
3
/ μL, respectively after ART. Proportion of leucopenia, neutropenia,
lymphocytopenia, anemia and thrombocytopenia was dropped from baseline 25.9% to 11.5% (pvalue=
0.000), 23.2% to 17.4% (p-value= 0.057), 24.1% to 9.1% (p-value= 0.000) 45% to
20.88% (p-value= 0.000) and 28.5% to 11.2% (p-value= 0.000), respectively. Nevertheless,
reduction in mean hemoglobin (p-value= 0.070) and high proportion of anemia (p-value= 0.000)
was observed in AZT than non-AZT containing ART treatment.
In conclusion, ART was effective in improving blood cell count and decreasing hematologic
abnormalities in HIV infected patients.
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Keywords
HIV, ART, Anemia, Neutropenia, Thrombocytopenia, CD4+ T cells