Profile of hematological abnormalities and its correlation with absolute CD4 count and human immunodeficiency virus viral load in human immunodeficiency virus-infected patients in a tertiary care hospital.

BACKGROUND

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.

MATERIALS AND METHODS

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.

RESULTS

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.

CONCLUSIONS

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.