Immuno-Haematological Abnormalities of HIV-Infected Patients Before and After Initiation of Highly Active Antiretroviral Therapy in the Antiretroviral Therapy Clinics of Six Health Facilities at Dessie Town, Northeast Ethiopia

Abstract

Background

In people living with the human immunodeficiency virus, haematological abnormalities have been linked to an increased risk of disease progression and mortality. Hematological parameters may have a positive or negative impact on antiretroviral therapy. The aim of this study was to assess the immuno-haematological abnormalities of HIV-infected patients before and after the initiation of highly active antiretroviral therapy in the antiretroviral therapy clinics of six health facilities in Dessie, Northeast Ethiopia.

Methods

A facility-based cross-sectional study was conducted from April to May 30, 2021, at the antiretroviral therapy clinics of six health facilities in Dessie Town. A total of 378 HIV-infected patients taking highly active antiretroviral treatment for at least 6 months by using a consecutive sampling technique were included. A well-organized questionnaire was used to collect socio-demographic and clinical information. Immune-haematological parameters were tested using a Mindray BS-300 hematology analyzer and a BD FACS count CD4 analyzer. Statistical analysis was performed using SPSS version 25 statistical software. Statistical significance was defined as a P-value of 0.05 with a 95% confidence interval.

Results

Leukopenia was found in 26.7% and 16.5%, neutropenia in 16.5% and 9.4%, lymphopenia in 20% and 3.1%, and thrombocytopenia in 25.9% and 7.1% of HIV patients before and after HAART initiation, respectively. There was a significant difference in total white blood cell, absolute neutrophil, red blood cell, hemoglobin value, mean cell volume, mean cell haemoglobin, mean cell haemoglobin concentration, red cell distribution width, platelet and CD4+ T cell counts in HIV patients before and after the initiation of HAART with P < 0.05.

Conclusion and Recommendation

Anemia, leukopenia, neutropenia, lymphopenia, and thrombocytopenia were the most common haematological abnormalities found in this study before and after HAART initiation. The prevalence of thrombocytopenia, immunosuppression, and viral load was reduced considerably after starting HAART.

Keywords:

• HIV
• anemia
• leukopenia
• thrombocytopenia
• HAART

Abbreviations

AIDS, acquired immune deficiency syndrome; ART, antiretroviral therapy; ANC, absolute neutrophil count; AZT/ZDV, Azidothymidine/Zidovudine; CBC, Complete blood count; CD4, cluster of differentiation 4; EDTA, Ethylene diamine tetra acetate; HAART, highly active antiretroviral therapy; HGB, Haemoglobin concentration; IQC, Internal quality control; LYM, Lymphocyte; MCH, Mean Corpuscular Haemoglobin; MCHC, Mean Corpuscular Haemoglobin Concentration; MCV, Mean Corpuscular Volume; NEUT, Neutrophils; PCV, Packed Cell Volume; PLT, Platelets; RBC, Red Blood Cells; SPSS, Statistical Package for Social Sciences; WBC, White Blood Cell; WHO, World Health Organization.

Data Sharing Statement

Data supplementary to the conclusions of this article are within the manuscript.

Acknowledgment

The authors would like to acknowledge the Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar Hospital, for giving me the opportunity to conduct this thesis work. All the study participants, APHI staffs especially Microbiology Department and the staffs of DRH are for their participation and support during the sample collection.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors state that they have no conflicts of interest in this research work.