Obiri-Yeboah D, Charwudzi A, Baidoo I K, Botchway E T, Addo S A, Nsiah P, Ekem I
Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Ghana.
Department of Haematology, School of Medical School Sciences, University of Cape Coast, Ghana.
West Afr J Med. 2020 Jan-Mar;37(1):40-47.
Haematological abnormalities such as anaemia, leucopenia, and thrombocytopenia are common complications of Human Immunodeficiency Virus (HIV) infection. Few researchers have studied the changes in HIV positive patients before and during antiretroviral therapy (ART) in Ghana. This study is aimed at determining the haematological profile of people living with HIV (PLHIV) at baseline and whilst on ART in a tertiary facility in Cape Coast, Ghana.
This was an analytical cross-sectional study with a retrospective component among PLHIV assessing ART services at the Cape Coast Teaching Hospital, Ghana. Full blood count (FBC) test was performed on blood samples and the results were analyzed and categorized based on WHO definitions.
A total of 440 participants were included. The mean haemoglobin level (g/dL) for females at baseline, 6 months after ART and during this study were 9.6 (±1.8), 10.9 (±1.4) and 11.6 (±1.4); and 10.2 (±2.1), 11.6 (±1.7) and 11.8 (±1.6) for males. At baseline, the commonest type of anaemia for both females and males was microcytic hypochromic anaemia. The mean platelet count was 382 x 109/l at baseline but reduced to 298 x 109/L after 6 months on ART. Among male participants in this study, the main factor associated with being anaemic after 6 months on ART was the ART regimen with non-Zidovudine based regimen, having reduced odds of anaemia of OR 0.3 (95%CI 0.1 - 0.9), p-value of 0.04. Among females, having plasma viral load >1000 copies per ml was found to have increased odds of being anaemic (OR 1.4, 95%CI 0.7 - 2.6), though not statistically significant (P-value of 0.32).
The prevalence of anaemia, though improved on ART, was high among PLHIV. It is essential to ensure that full blood count of PLHIV in Ghana are done regularly, at all levels of service provision, with appropriate referral systems in place. The change to the current TDF based preferred first line ART regimen must also be enforced to reduce the potential risks associated with AZT use. This will improve outcome for PLHIV.
贫血、白细胞减少和血小板减少等血液学异常是人类免疫缺陷病毒（HIV）感染的常见并发症。在加纳，很少有研究人员对HIV阳性患者在抗逆转录病毒治疗（ART）之前和期间的变化进行研究。本研究旨在确定加纳海岸角一家三级医疗机构中接受ART治疗的HIV感染者（PLHIV）在基线期及治疗期间的血液学特征。
这是一项分析性横断面研究，对加纳海岸角教学医院接受ART治疗的PLHIV进行回顾性评估。对血样进行全血细胞计数（FBC）检测，并根据世界卫生组织的定义对结果进行分析和分类。
共纳入440名参与者。女性在基线期、ART治疗6个月后及本研究期间的平均血红蛋白水平（g/dL）分别为9.6（±1.8）、10.9（±1.4）和11.6（±1.4）；男性分别为10.2（±2.1）、11.6（±1.7）和11.8（±1.6）。在基线期，女性和男性最常见的贫血类型均为小细胞低色素性贫血。基线期平均血小板计数为382×10⁹/L，但ART治疗6个月后降至298×10⁹/L。在本研究的男性参与者中，ART治疗6个月后贫血的主要相关因素是采用非齐多夫定类方案的ART治疗方案，贫血几率降低，比值比为0.3（95%置信区间0.1 - 0.9），p值为0.04。在女性中，血浆病毒载量>1000拷贝/ml被发现贫血几率增加（比值比1.4，95%置信区间0.7 - 2.6），但无统计学意义（p值为0.32）。
尽管ART治疗后贫血患病率有所改善，但PLHIV中的贫血患病率仍然很高。必须确保在加纳各级服务机构定期对PLHIV进行全血细胞计数，并建立适当的转诊系统。还必须强制改用目前基于替诺福韦酯的首选一线ART治疗方案，以降低与使用齐多夫定相关的潜在风险。这将改善PLHIV的治疗效果。
