A Prospective, Single Centric Study of Hematological Profile in HIV Infected Patients with Correlation to CD4 Count
A Prospective, Single Centric Study of Hematological Profile in HIV Infected Patients with Correlation to CD4 Count
Keywords:
CD4, HIV, Haematological changesAbstract
Background & objectives: A variety of haematological manifestations is seen at every stage of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and often pose a great challenge in the comprehensive management. These manifestations also reflect the underlying immune status if interpreted cautiously, especially if the patient is in regular follow-up. They may cause symptoms that are life-threatening and impair the quality of life of these patients. Methods: Blood samples collected in the ART centre send to the central pathology laboratory, Sir Takhtasinhji General Hospital, Bhavnagar. Haematological parameters were analysed by automated haematology analyser and peripheral smear examination. CD4 count was done by automated analyser. Descriptive statistics were applied. Association between two attributes was calculated by chi-square test, Kruskal-Wallis test, one way ANOVA test, unpaired t test and Mann Whitney test and P value less than 0.05 was considered statistically significant. Results: Comparison between CD4 count and haematological changes shows that p value is significant (P<0.05) in haemoglobin, total leucocyte count, differential leucocyte count except absolute eosinophil count, platelet, PCV and blood indices except in MCHC. Male: Female ratio is 2:1. 86 % was sexually transmitted, 1.6% by blood transfusion, 7.4% by vertical transmission, 5% by unknown reason. Maximum 44.4% patients have CD4 count between 200-499 cells/cumm. Anaemia is present in 47.4% patients. Leucopenia is present in 11.2% patients. Lymphopenia is present in 12.8% patients and eosinophilia is present in 6% patients. Thrombocytopenia is present in 8.6% patients. Interpretation & conclusion: Haematological changes are occurs along with changes in CD4 count and disease progression. Along with changes in CD4 count changes in haemoglobin, leucocytes and platelet occurs along with other haematological changes. Haematological parameters correlate with level of CD4 count. [Heema C NJIRM 2017; 8(2):169-176]
References
2. Volberding PA, Baker KR, Levine AM. Humanimmunodeficiency virus hematology. Hematology Am SocHematolEduc Program 2003;:294-313.
3. Coyle TE. Hematologic complications of humanimmunodeficiency virus infection and the acquired immunodeficiency syndrome. Med Clin North Am. 1997;81:449-70.
4. Salond E. Hematologic complications of HIV infection. AIDS Rev 2005;7:187-96.
5. Cosby CD. Hematologic disorders associated with human immunodeficiency virus and AIDS. J InfusNurs. 2007;30:22-32.
6. Adediran IA, Durosinmi MA. Peripheral blood and bone marrow changes in patients with acquired immunodeficiency syndrome. Afr J Med Med Sci. 2006 Dec;35:85-91.
7. Kothari K, Goyal S. Clinical profile of AIDS. J Assoc Physicians India. 2001 Apr;49:435-8.
8. Sircar AR , Tripathi AK , Choudhary SK , Misra R. Clinical profile of AIDS: a study at a referral hospital. The Journal of the Association of Physicians of India.1998; 46(9):775-778.
9. KambleKB ,Sneha K, Ramesh K.A Descriptive study on clinical profile of patients with HIV in a Tertiary care hospital. Int.J.Curr.Aca.Rev.2014;2(10):137-143.
10. Keshava H.K ,Manjunath R. Correlation between clinical profile, cd 4 count and total lymphocyte count in hiv infected persons. Journal of Evolutionof Medical and Dental Sciences. 2014 Feb; 3(05): 1264-1275.
11. Obirikorang C, Yeboah FA. Blood haemoglobin measurement as a predictive indicator for the progression of HIV/AIDS in resource-limited setting. J Biomed Sci. 2009 Nov;16(1): 102.
12. Wankah PN, Tagny CT, and Mbanya DNS. Profile of blood cell abnormalities among antiretroviral therapy naïve HIV patients attending the Yaounde University Teaching Hospital, Cameroon. BMC Hematol. 2014 Sep; 14: 15.
13. Parinitha SS and Kulkarni MH. Haematological changes in HIV infection with correlation to CD4 cell count. Australas Med J. 2012; 5(3): 157–162.
14. Kaloutsi V, Kohlmeyer U, Maschek H, Nafe R, Choritz H, Amor A, et al. Comparison of bone marrow and hematologic findings in patients with human immunodeficiency virus infection and those with myelodysplastic syndromes and infectious diseases. Am J ClinPathol. 1994 Feb;101(2):123–9.
15. Treacy M, Lai L, Costello C, Clark A. Peripheral blood and bone marrow abnormalities in patients with HIV related disease. Br J Haematol. 1987;65:289–94.
16. Karcher DS, Frost AR. Bone marrow in human immunodeficiency virus (HIV)-related disease morphology and clinical correlation. Am J ClinPathol. 1991 Jan;95(1):63–71.
17. Tripathi AK, Kalra P, Misra R, Kumar A, Gupta N. Study of bone marrow abnormalities in patients with HIV disease. JAPI. 2005 Feb;53:105–10.
18. Sitalakshmi S, Srikrishna A, Damodar P. Hematologic changes in HIV infection. Indian J PatholMicrobiol. 2003;46(2):180–3.
19. Khandekar MM, Deshmukh SD, Holla VV, Rane SR, Kakrani AL, Sangale SA, et al. Profile of bone marrow examination in HIV/AIDS patients to detect opportunistic infections, especially tuberculosis. Indian J PatholMicrobiol. 2005;48(1):7–12.
