Owiredu W K B A, Quaye L, Amidu N, Addai-Mensah O
Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Afr Health Sci. 2011 Mar;11(1):2-15.
Highly active antiretroviral therapy (HAART) for people living with HIV/AIDS (PLWHA) has been generally accepted as the gold standard for the management of HIV patients but conflicting reports about the ability of HAART to improve upon the quality of life of HIV patients has cast doubts over the efficacy and the need for therapy.
This study was conducted to assess the efficacy and ability of HAART to resolve immunological and haematological abnormalities in HIV infected patients, existent sex variations in immunological and haematological parameters and CD4 predictive ability of the study parameters.
A total of 442 PLWHA consisting of 166 patients on HAART (28 males and 138 females) and 276 HAART-naïve patients (76 males and 200 females) were recruited for this study. Complete haemogram, immunological analysis (CD4 & CD3) and weight were measured for all the patients.
HAART patients were older and heavier than their naïve counterparts. The incidence of anaemia (Hb less or equal to 10.5 (63%) and PCV < 30% (37.6%)) and lymphopoenia (16.7%) in HAART-naïve patients was significantly higher compared to their counterparts on HAART (46%, 15.2% and 5.3%) respectively. 70% of HAART-naïve females had anaemia in comparison to 44% in HAART-naïve males (P = 0.0001). The likelihood of developing microcytic hypochromic anaemia in HAART-naïve patients was 5 times more compared to those on HAART (P = 0.0002). Total lymphocyte count, haemoglobin, lymphocyte count and weight were significant predictors of CD4 counts and TLC values between 1.0 - 2.0 k µL(-1) was a significant predictor of CD4 <200 cells mm(-3).
HAART has the capability of reducing the incidence of anaemia and lymphopoenia which are associated with disease progression and death in HIV infected patients. Total lymphocyte count, haemoglobin and weight could also serve as useful predictive tools in the management and monitoring of HIV infected patients in resource limited settings.
高效抗逆转录病毒疗法（HAART）已被普遍视为艾滋病毒/艾滋病患者（PLWHA）治疗的金标准，但关于HAART能否改善艾滋病毒患者生活质量的报道相互矛盾，这让人对该疗法的疗效及必要性产生怀疑。
本研究旨在评估HAART在解决艾滋病毒感染患者免疫和血液学异常方面的疗效及能力、免疫和血液学参数中存在的性别差异以及研究参数的CD4预测能力。
本研究共招募了442名PLWHA，其中166名接受HAART治疗的患者（28名男性和138名女性）以及276名未接受过HAART治疗的患者（76名男性和200名女性）。对所有患者进行了全血细胞计数、免疫分析（CD4和CD3）及体重测量。
接受HAART治疗的患者比未接受治疗的患者年龄更大、体重更重。未接受HAART治疗的患者中贫血（血红蛋白低于或等于10.5（63%）且红细胞压积<30%（37.6%））和淋巴细胞减少症（16.7%）的发生率显著高于接受HAART治疗的患者（分别为46%、15.2%和5.3%）。未接受HAART治疗的女性中有70%患有贫血，而未接受HAART治疗的男性中这一比例为44%（P = 0.0001）。未接受HAART治疗的患者发生小细胞低色素性贫血的可能性是接受HAART治疗患者的5倍（P = 0.0002）。总淋巴细胞计数、血红蛋白、淋巴细胞计数和体重是CD4计数的重要预测指标，而TLC值在1.0 - 2.0 k µL(-1)之间是CD4<200细胞/mm(-3)的重要预测指标。
HAART有能力降低与艾滋病毒感染患者疾病进展和死亡相关的贫血和淋巴细胞减少症的发生率。在资源有限的环境中，总淋巴细胞计数、血红蛋白和体重也可作为管理和监测艾滋病毒感染患者的有用预测工具。
