INTRODUCTION:
The HIV epidemic, is a convincing illustration of the balance
between the power of science and the humanism of modern
medicine. The epidemic is so serious that between 1981 and 2000,
21.8 million people had died of HIV/AIDS1.
Clinically significant hematologic abnormalities are common
in HIV infection. Hematologic abnormalities are among the most
common complications of infection with HIV2. These abnormalities
are due to:
• Impaired hematopoiesis.
• Immune mediated cytopenias and,
• Altered coagulation mechanisms.
These abnormalities may occur as a result of HIV infection
itself, as sequelae of HIV related opportunistic infections or
malignancies or as a consequence of therapies used for HIV
infection and associated conditions.
Despite the availability of various categories of diagnostic and
monitoring techniques for HIV/AIDs, the costs of it are still
unaffordable to several people in the resource poor settings. Early
identification of the hematologic abnormalities would lead to
appropriate planning of treatment strategies.
Hence, this study was conducted in order to know the pattern
of these hematologic abnormalities among PLHA’s.
AIMS AND OBJECTIVES:
1. To analyse the hematological profile of people living
with HIV/AIDS (PLHA’s).
2. To identify the possible correlation between WHO
clinical stage and hematological abnormalities if any.
MATERIALS:
Subjects: All patients with HIV infection attending Govt. General
Hospital between May 2005 - May 2007.
Period of Study: May 2005 to May 2007.
Design of Study: Prospective Study.
Eligibility Criteria:
1. All patients with HIV infection.
2. HIV infection proven by ELISA & western blot assay.
Exclusion Criteria:
1. Chronic infection like tuberculosis.
2. Alcoholics.
3. Worm infestations.
4. Chronic kidney disease.
5. Drug intake (phenytoin).
6. Patient on anti retroviral therapy.
Methodology:
All patients with HIV infection attending Govt. General
Hospital during the study period were evaluated for the conditions
which could alter the Hematological parameters and if found so, they
were excluded from the study.
Those included in the study were investigated for Hb% total
count, differential count, ESR and platelet count. CD4 count done by
flow cytometric analysis was obtained. They were staged as per the
WHO clinical staging given by the National AIDS control
organisation (NACO)
OBSERVATIONS:
100 patients with HIV infection were included in the study
after excluding for all possible parameters that could affect the blood
cell counts. Before the initiation of anti retroviral therapy they were
investigated for Hb, total count, differential count, CD4 count,
platelet count and erythrocyte sedimentation rate (ESR).
CONCLUSION:
100 PLHA’s were analysed for the Hematological
abnormalities in HIV/AIDs.
• Majority of them were in stage III (55%) and had CD4 count <200/microlitre (87%).
• Leucopenia was found in 41% of them.
• Neutropenia was detected in 29%.
• Thrombocytopenia was found in 40%
• Anemia and elevated ESR detected in 79% and 71%
respectively.
• Lymphocytopenia was detected in 30% of PLHA’s who
also had low CD 4 count as per the WHO documents.
• The analysis of correlation between WHO staging and
hematologic abnormalities revealed statistically
significant relation only with anemia