Suja S, Saravanan T, Karthikeyan S
Department of General Medicine, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.
Department of Community Medicine, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.
Indian J Sex Transm Dis AIDS. 2020 Jul-Dec;41(2):156-161. doi: 10.4103/ijstd.IJSTD_56_19. Epub 2020 Jul 31.
A variety of hematological manifestations are seen at every stage of human immunodeficiency virus (HIV) infection, and they often pose a great challenge in the comprehensive management of acquired immunodeficiency syndrome. Anemia is the most common hematological abnormality associated with HIV infection. The severity and the incidence of cytopenia are usually correlated with the stage of the disease and underlying immune status if interpreted cautiously, especially if the patient is on regular follow-up. The primary objective of the present study was to understand the spectrum of hematological abnormalities in HIV-infected patients, whereas the secondary objective was to evaluate the correlation of hematological abnormalities with absolute CD4 count and HIV viral load.
The present cross-sectional descriptive study was conducted on 100 patients, aged 18 years and above, diagnosed with HIV infection and confirmed by Western blot or ELISA method. Both inpatients and outpatients at our tertiary care hospital were included in the study.
Individuals with high viral load and low CD4 count had a higher prevalence of anemia. There was a statistically significant and directly proportionate decrease in the absolute CD4 count as the hemoglobin levels decreased ( = 0.004). In the present study, normocytic normochromic blood picture and anemia of chronic disease blood picture were more prevalent among the study participants. Individuals with high viral load and CD4 count <200 cells/mm had a higher rate of occurrence of coinfections. The correlation of absolute neutrophil count and thrombocytopenia with absolute CD4 count and HIV viral load was not statistically significant.
Complete blood counts and peripheral smear observations were significantly correlated with high HIV viral load and lower absolute CD4 cell counts and therefore can be suggested as economical alternatives for the evaluation of the status of HIV disease stage and its progression.
在人类免疫缺陷病毒（HIV）感染的各个阶段都会出现多种血液学表现，它们在获得性免疫缺陷综合征的综合管理中常常构成巨大挑战。贫血是与HIV感染相关的最常见血液学异常。如果谨慎解读，血细胞减少的严重程度和发生率通常与疾病阶段及潜在免疫状态相关，尤其是在患者接受定期随访的情况下。本研究的主要目的是了解HIV感染患者血液学异常的范围，次要目的是评估血液学异常与绝对CD4细胞计数及HIV病毒载量的相关性。
本横断面描述性研究对100例18岁及以上经蛋白免疫印迹法或酶联免疫吸附测定法确诊为HIV感染的患者进行。我们三级护理医院的住院患者和门诊患者均纳入研究。
病毒载量高且CD4细胞计数低的个体贫血患病率更高。随着血红蛋白水平下降，绝对CD4细胞计数有统计学意义的直接成比例下降（=0.004）。在本研究中，正细胞正色素性血象和慢性病性贫血血象在研究参与者中更为普遍。病毒载量高且CD4细胞计数<200个/立方毫米的个体合并感染发生率更高。绝对中性粒细胞计数和血小板减少与绝对CD4细胞计数及HIV病毒载量的相关性无统计学意义。
全血细胞计数和外周血涂片观察结果与高HIV病毒载量及较低的绝对CD4细胞计数显著相关，因此可作为评估HIV疾病阶段及其进展状况的经济替代方法。
