Comparative study on Changes in Hematological Parameters during the First 6 month of Antiretroviral Therapy initiation Among HIV infected pregnant and non-Pregnant women at Zewditu Memorial Hospital, Addis Ababa, Ethiopia
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Date
2016-06
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Addis Ababa University
Abstract
Background: The use of ARV prophylaxis during pregnancy can dramatically reduce the risk of
vertical transmission of HIV infection. Currently, limited studies have documented the effect of
ART in decreasing the risk of opportunistic infection as well as improving survival of HIV
infected pregnant women and fetus. However, little is known about its impact on hematological
parameters in resource limited settings like Ethiopia.
Objective: To assess changes in hematological parameters after 6 months of ART initiation
among HIV infected pregnant and non-pregnant women at Zewditu Memorial Hospital ART
clinic, Addis Ababa, Ethiopia.
Methodology: A retrospective comparative study was conducted among HIV infected
pregnant women who received ART between September 2008 and January 2014 at ART
clinic of Zewditu Memorial Hospital, Addis Ababa, Ethiopia. Data conveniently collected from
384 pregnant women on ART was compared with that obtained from 384 non pregnant women
who are on ART as controls. Demographic, clinical and hematological parameters data were
collected between November and December 2016 carefully from the existing ART logbook and
antenatal follow up cards. Data collected through a standardized format were entered into
Excel spread sheet and transported into and analyzed by SPSS Version 20 software.
Dependent variable frequencies, mean, standard deviation and range were calculated. Mean
change of different hematological values during follow up time from the base line were
compared using paired t-test. P value <0.05 was considered as statistically significant.
Results: The results of the study indicated significant difference in RBC Count, Hb, HCT, MCV,
MCH,MCHC PLT counts were statistically significantly lower, while CD4 count was
significantly higher in HIV infected pregnant women compared to non pregnant women. There
was no statistically significant difference between the two groups for PLT and total WBC.
Prevalence of anemia, leucopenia, thrombocytopenia and CD4+ T lyphocytopenia at baseline
and 6 months of follow up were 49.5% vs 54.4%, 20.7% vs 4.9% , 20.8% vs 18.8% and 88.8%
vs 69.8% for HIV infected pregnant women, respectively. The respective values in HIV infected
non pregnant women were 37% vs 18% , 8.6% vs 5.8% ,38% vs 7.8% and 58.6% vs
34.1.Microcytic hypochromic anemia was the dominant type in the pregnant women while
normocytic hypochromic was the commonest followed by microcytic hypochromic anemia in the
non-pregnant women. Thus, monitoring of all hematological parameters (not only Hb) is
warranted.
Conclusion: Comparison of hematological parameters of HIV infected pregnant with non
pregnant significant changes. Since these parameters are strongly influenced as a result of
pregnancy.
Key words: Pregnant women, Hematological parameters, anemia, thrombocytopenia, CD4+ T
cells and ART
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Keywords
Pregnant women, Hematological parameters, Anemia, Thrombocytopenia, CD4+T Cells