Hematologic Abnormalities in HIV Patients before Exposure to Antiretroviral Agents

Abstract

Objectives: To determine the prevalence of hematologic abnormalities and their associations with CD4 count levels in human immunodeficiency virus (HIV) patients before exposure to antiretroviral drugs.

Methods: This study was a retrospective descriptive study of HIV patients before exposure to antiretroviral drugs at Faculty of Medicine Vajira Hospital between 2004 and 2010. Inclusion criteria were age of 20 to 60 years old and had no chronic illness, no hepatitis B virus (HBV) or hepatitis C virus (HCV) co-infection, no current medication or other conditions which may affect hematological system. The patients must also have complete record of complete blood cell count (CBC) as well as CD4 cell count.

Results: We included 215 HIV patients: 47.0% male and 53.0% female. The mean age was 37.3 ฑ 7.9 years old. The most frequent hematologic abnormality was anemia (60.5%) followed by lymphopenia (27.9%), leucopenia (16.7%), neutropenia (14.4%) and thrombocytopenia (9.3%). From 215 HIV patients, 72.6% had CD4 < 200/ตL. Comparing between those with CD4 < 200/ตL and CD4 ณ 200/ตL groups; there were significantly higher prevalence of anemia (67.3% vs 42.4%; p-value < 0.001), leucopenia (21.8% vs 3.4%; p-value = 0.001), and lymphopenia (37.2% vs 3.4%; p-value < 0.001) in the former group. However, there was no significant difference of neutropenia (14.1% vs 15.3%; p-value = 0.830) and thrombocytopenia (11.5% vs 3.4%; p-value = 0.066) between the two groups.

Conclusion: The most frequent hematologic abnormality in HIV patients before exposure to antiretroviral agents was anemia followed by lymphopenia and leucopenia. These abnormalities were significantly higher in patients with CD4 < 200/ตL.

Keywords: HIV, CD4, hematologic abnormalities, anemia, leucopenia, lymphopenia