Assistant Professor, Department of Medicine, NKPSIMSR, Nagpur, Maharashtra.
Mediterr J Hematol Infect Dis. 2013 Jun 3;5(1):e2013033. doi: 10.4084/MJHID.2013.033. Print 2013.
Hematological abnormalities are a common complication of HIV infection. Bone marrow abnormalities occur in all stages of HIV infection. Present work was carried out to study the bone marrow abnormalities in patients with HIV/AIDS.
160 patients of HIV +ve were included in the study. A complete blood count, relevant biochemical investigations, CD4 counts were done, besides a thorough history and clinical examination. HIV positive patients were classified as those having AIDS and those without AIDS according to NACO criteria. Bone marrow examination was performed for indication of anemia, leucopenia, pancytopenia and thrombocytopenia.
As per CDC criteria 59.81% patients had AIDS in 107 patients. The most common hematological abnormality was anemia, seen in 93.12% patients. Bone marrow was normocellular in 79.06% of non-AIDS and 79.68% of AIDS, hypocellular in 13.95% of non-AIDS and 12.5% of AIDS, hypercellular in 06.97% of non-AIDS and 07.81 % of AIDS patients. Dysplasia was statistically and significantly associated with anemia. For myelodysplasia in bone marrow in HIV patients we noted granulocytic dysplasia in 4.65% in Non - AIDS and 14.06% AIDS patients. Erythroid dysplasia was found in 9.30% in Non - AIDS, 12.5% in AIDS group. Thrombocytopenia was seen in 4 cases of ART (4.93%) and 3 cases (4.68%) of AIDS group. Abnormal cells like plasma cell, histiocyte and toxic granule were found in bone marrow.
Myelodysplasia was more common in AIDS than in non AIDS patients. Granulocytic series is most commonly associated with evidence of dysplasia. Anemia in HIV patients can be a good clinical indicator to predict and access the underlying immune status. Thus bone marrow study is imperative to methodically observe and follow clinical and laboratory aberration in such patients in order to improve our diagnostic and therapeutic skills pertinent to HIV/AIDS.
血液学异常是 HIV 感染的常见并发症。骨髓异常发生在 HIV 感染的所有阶段。本研究旨在研究 HIV/AIDS 患者的骨髓异常。
纳入 160 例 HIV 阳性患者。除了详细的病史和临床检查外，还进行了全血细胞计数、相关生化检查、CD4 计数以及 HIV 阳性患者根据 NACO 标准分为 AIDS 患者和非 AIDS 患者。骨髓检查用于贫血、白细胞减少症、全血细胞减少症和血小板减少症的指征。
根据 CDC 标准，107 例患者中有 59.81%患有 AIDS。最常见的血液学异常是贫血，见于 93.12%的患者。非 AIDS 患者骨髓正常细胞为 79.06%，AIDS 患者为 79.68%，非 AIDS 患者低细胞为 13.95%，AIDS 患者为 12.5%，高细胞为 06.97%，AIDS 患者为 07.81%。骨髓增生异常与贫血具有统计学和显著相关性。对于 HIV 患者的骨髓骨髓增生异常，我们发现非 AIDS 患者为 4.65%，AIDS 患者为 14.06%的粒细胞增生异常。非 AIDS 患者中发现 9.30%的红细胞增生异常，AIDS 组为 12.5%。ART 中发现 4 例血小板减少症（4.93%），AIDS 组中发现 3 例（4.68%）。骨髓中发现浆细胞、组织细胞和毒性颗粒等异常细胞。
骨髓增生异常在 AIDS 患者中比非 AIDS 患者更常见。粒细胞系列最常与发育不良的证据相关。HIV 患者的贫血可以作为预测和评估潜在免疫状态的良好临床指标。因此，骨髓研究对于系统地观察和随访此类患者的临床和实验室异常以提高我们与 HIV/AIDS 相关的诊断和治疗技能至关重要。
