Abay Feven, Yalew Aregawi, Shibabaw Agumas, Enawgaw Bamlaku
Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Tuberc Res Treat. 2018 Dec 30;2018:5740951. doi: 10.1155/2018/5740951. eCollection 2018.
Hematological abnormalities are common in pulmonary tuberculosis (PTB) patients, which is one of the major public health problems worldwide. However, there is paucity of information about the hematological profile of PTB patients with and without HIV in the study area. Therefore, this study aimed to assess hematological abnormalities of pulmonary tuberculosis patients with and without HIV at the University of Gondar Hospital, Northwest Ethiopia.
A comparative cross-sectional study was conducted at the University of Gondar Hospital. Sociodemographic data was collected using a pretested, structured questionnaire. Five milliliters of venous blood sample was collected and divided into a 3 ml EDTA tube for complete blood count with the Cell Dyn 1800 hematological analyzer and a 2 ml citrated tube for erythrocyte sedimentation rate determination. Data were entered into Epi Info version 3.5.3 and then transferred to SPSS 20 for analysis. The independent samples -test was used to compare the mean values of hematological parameters between PTB patients and PTB-HIV coinfected patients.
A total of 100 study subjects (50 PTB and 50 PTB-HIV coinfected) were included with a mean age of 31.3 ± 10.3 years for PTB patients and 32.1 ± 9.2 years for PTB-HIV coinfected patients. In this study, there were significantly lower mean values of Hgb ( = 0.049), platelet count ( < 0.001), and neutrophils counts ( = 0.007) among PTB-HIV coinfected patients when compared with PTB patients. Of the PTB infected patients 46% were anemic, 6% leukopenic, 22% neutropenic, 8% lymphopenic, and 8% thrombocytopenic. On the other hand, of the PTB-HIV coinfected patients 60% were anemic, 14% leukopenic, 66% neutropenic, 12% lymphopenic, and 20% thrombocytopenic. ESR value was increased in all patients.
This study demonstrated high prevalence of neutropenia, anemia, and thrombocytopenia among PTB-HIV coinfected patients. HIV coinfection worsens hematological abnormalities of PTB patients. Assessment of hematological parameters can be used as an indicator in the diagnosis and follow-up of PTB patients coinfected with HIV. We recommended assessment of PTB patients with or without HIV for various hematological disorders such as neutropenia, anemia, and thrombocytopenia.
血液学异常在肺结核（PTB）患者中很常见，肺结核是全球主要的公共卫生问题之一。然而，在研究区域内，关于合并或未合并HIV的PTB患者血液学特征的信息匮乏。因此，本研究旨在评估埃塞俄比亚西北部贡德尔大学医院合并或未合并HIV的肺结核患者的血液学异常情况。
在贡德尔大学医院进行了一项比较性横断面研究。使用经过预测试的结构化问卷收集社会人口统计学数据。采集5毫升静脉血样本，将其分为3毫升用于乙二胺四乙酸（EDTA）抗凝管，通过Cell Dyn 1800血液分析仪进行全血细胞计数；以及2毫升枸橼酸盐抗凝管，用于测定红细胞沉降率。数据录入Epi Info 3.5.3版本，然后转移至SPSS 20进行分析。采用独立样本t检验比较PTB患者与合并HIV的PTB患者血液学参数的平均值。
共纳入100名研究对象（50名PTB患者和50名合并HIV的PTB患者），PTB患者的平均年龄为31.3±10.3岁，合并HIV的PTB患者的平均年龄为32.1±9.2岁。在本研究中，与PTB患者相比，合并HIV的PTB患者的血红蛋白（Hgb）平均值（P = 0.049）、血小板计数（P < 0.001）和中性粒细胞计数（P = 0.007）显著更低。在PTB感染患者中，46%为贫血，6%为白细胞减少，22%为中性粒细胞减少，8%为淋巴细胞减少，8%为血小板减少。另一方面，在合并HIV的PTB患者中，60%为贫血，14%为白细胞减少，66%为中性粒细胞减少，12%为淋巴细胞减少，20%为血小板减少。所有患者的红细胞沉降率（ESR）值均升高。
本研究表明合并HIV的PTB患者中中性粒细胞减少、贫血和血小板减少的患病率很高。HIV合并感染会使PTB患者的血液学异常恶化。血液学参数评估可作为合并HIV的PTB患者诊断和随访的一项指标。我们建议对合并或未合并HIV的PTB患者进行各种血液学疾病如中性粒细胞减少、贫血和血小板减少的评估。
