Assessment of Antiphospholipid Antibodies, CD4
Count and Some Haematological Parameters in HIV
Patients attending a Tertiary Health Institution in
South-Western Nigeria
Antiphospholipid antibodies (aPLs) are the serological markers used in the diagnosis
of the antiphospholipid syndrome (APS). HIV infe
ction has been as
sociated with an elevated aPls
level, but its link to the APS with clin
ical thrombosis is still been investigated
.
This study is designed
to determine and correlate serum level of antiphospholipid antibodies with CD4 count and some
haematological parameters of HIV se
ropositive subjects in comparison to those of healthy controls and also to compare these parameters between an
tiretroviral therapy (ART) naïve and treated
patients.
Methodology:
A cohort of 110 patients which consist of
90 HIV positive Patients (22 males and 68
females) and 20 HIV negative patients (10 males and
10 females) which serve as control attending
Babcock University Teaching Hospital (BUTH) Ilisha
n-Remo, Ogun State, Nigeria were recruited for
the cross-sectional study. HIV anti
bodies were detected using 3 rapid diagnostic kits (Determine,
Unigold and Stat Pak). CD4+ cells were counted us
ing Partec® Cyflow Counter (Germany). The Full
Blood Count was analyzed using the Sysmex® Auto
mated Haematology Analyzer (Kobe-Japan).
Antiphospholipid antibodies (aPLs) were assayed using the Human Anti-Phospholipid Screen
IgG/IgM ELISA kit (Alpha Diagnostic International, Texas, U
SA).
Results:
The present study showed that the mean se
rum antiphospholipid antibody level was
significantly (P<0.001) higher in HIV positive Pa
tients (11.83±7.36u/ml) compared to the control
group (7.30±3.95u/ml). While on one hand, there was
a strong positive correlation between serum
aPLs level and PLT (r= 0.044), MCHC (r= 0.084)
and LYM (r= 0.105) in HIV
infection; on the other
hand, there was a strong negative correl
ation with CD4 count (r= -0.094), PCV (r= -0.099), Hb (r= -
0.072), RBC (r= -0.003), WBC (r= -0.063), MNO (r= -0
.213), GRA (r= -0.003), MCV (r= -0.023) and
MCH (r= -0.005). Also, there was no significant diffe
rences (P>0.05) between the aPLs level of HIV
group on ART (11.44±7.74 u/ml) and those not on
ART (12.00±7.24 u/ml). Some haematological
parameters like PLT, PCV, Hb, RBC and red cell
indices of the HIV group on ART did not differ
significantly from those not on ART. However, the CD4 count (638.89±119.56 cell/
μ
L), WBC
(5.38±1.49X10
3
/
μ
L), LYM (51.43±7.99%) and GRA (46.30±10.
18%) of the HIV group on ART were
significant higher than those not on ART (465.30±145.92 cell/
μ
L, 4.55±1.57X10
3
/
μ
L, 42.23±10.96%
and 39.10±7.81%, respectively).
Conclusion:
Significant elevated aPLs level is present
in HIV infection; however, the information
obtained is not sufficient to indicate the occurrence
of anti-phospholipid sy
ndrome in HIV infection.
There was no strong relationship between aPLs
level and indicators of immunohaematological
abnormalities in HIV infection. This finding is plausible and would therefore require further
investigation