Medical Research Council/Uganda Virus Research Institute Uganda Research Unit on AIDS, Entebbe, Uganda.
Trop Med Int Health. 2010 Jan;15(1):105-12. doi: 10.1111/j.1365-3156.2009.02428.x. Epub 2009 Nov 23.
To assess the degree of haematological and biochemistry abnormalities associated with splenomegaly in asymptomatic adults in order to determine whether they may be eligible for inclusion in HIV biomedical prevention trials.
Asymptomatic adults (50% women) aged 18-60 with splenomegaly (>or=grade II by Hackett's classification) who agreed to provide blood and urine specimens for laboratory testing were invited to participate in a cross-sectional study. Volunteers who were menstruating, pregnant, infected with HIV, syphilis or Hepatitis B and C, or had significant clinical findings were excluded. Haematological and biochemistry laboratory evaluations were performed for enrolled volunteers, and the results were compared to local reference ranges. The proportion of volunteers with out-of-range (OOR) values was estimated for each parameter. Linear regression models were fitted to investigate the association between grade of splenomegaly and laboratory values.
The proportion of volunteers with OOR haematology values ranged from 4.5% (mean corpuscular volume) and 15% (CD4 cells) to 31% (basophils). Increasing spleen size was significantly associated with anaemia, thrombocytopenia and low CD4 count. OOR biochemistry values were found in about 10% of volunteers. Increasing spleen size was associated with reduced creatinine phosphokinase and creatinine (in men) and raised lactate dehydrogenase.
In areas with a high prevalence of splenomegaly, most asymptomatic individuals with this condition have haematology and biochemistry values that fall within the local reference ranges, and they could therefore be eligible for inclusion in HIV biomedical prevention trials. However, the effect of splenomegaly on certain parameters should be taken into account during interpretation of laboratory-based adverse events.
评估无症状成年人脾肿大相关血液学和生物化学异常的程度，以确定他们是否有资格参加 HIV 生物医学预防试验。
本研究纳入了 18-60 岁、无症状（50%为女性）、脾肿大（Hackett 分级≥Ⅱ级）且愿意提供血液和尿液标本进行实验室检测的成年人。研究排除了正在月经期、妊娠、感染 HIV、梅毒或乙型肝炎和丙型肝炎，或有明显临床发现的志愿者。对入组志愿者进行血液学和生物化学实验室评估，并将结果与当地参考范围进行比较。对于每个参数，估计了超出范围（OOR）值的志愿者比例。拟合线性回归模型来研究脾肿大程度与实验室值之间的关系。
OOR 血液学值的志愿者比例范围为 4.5%（平均红细胞体积）至 15%（CD4 细胞）至 31%（嗜碱性粒细胞）。脾肿大程度增加与贫血、血小板减少和低 CD4 计数显著相关。约 10%的志愿者存在 OOR 生化值。脾肿大程度增加与肌酸磷酸激酶和肌酐降低（男性）以及乳酸脱氢酶升高相关。
在脾肿大流行率较高的地区，大多数患有这种疾病的无症状个体的血液学和生物化学值都在当地参考范围内，因此他们可能有资格参加 HIV 生物医学预防试验。然而，在解释基于实验室的不良事件时，应考虑脾肿大对某些参数的影响。
