埃塞俄比亚中北部德布雷塔博尔综合专科医院成人HIV感染患者开始高效抗逆转录病毒治疗前后的血液学异常：一项横断面研究。
Hematological Abnormalities of Adult HIV-Infected Patients Before and After Initiation of Highly Active Antiretroviral Treatment at Debre Tabor Comprehensive Specialized Hospital, Northcentral Ethiopia: A Cross-Sectional Study.
作者信息
Damtie Shewaneh, Workineh Lemma, Kiros Teklehaimanot, Eyayu Tahir, Tiruneh Tegenaw
机构信息
Debre Tabor University, College of Health Sciences, Department of Medical Laboratory Science, Debre Tabor, Ethiopia.
出版信息
HIV AIDS (Auckl). 2021 May 4;13:477-484. doi: 10.2147/HIV.S308422. eCollection 2021.
BACKGROUND
Hematological abnormalities have been associated with an increased risk of disease progression and death in people living with human immunodeficiency virus (HIV). The use of antiretroviral medications can have a positive or negative effect on the hematological disorder. However, little is known about its impact on hematological parameters in antiretroviral-treated patients in Ethiopia, especially in the study area.
METHODS
A cross-sectional study was conducted at Debre Tabor Comprehensive Specialized Hospital from September to November 2020. A total of 334 HIV-infected patients taking highly active antiretroviral treatment (HAART) at least for 6 months were selected using a simple random sampling technique. Socio-demographic and clinical characteristics of the study subjects were collected using a semi-structured questionnaire. Hematological and immunological parameters were determined using Sysmex kx-21 hematology analyzer and BD FACS count CD4 analyzer, respectively. Statistical analysis was done using SPSS version 20 statistical software. A P-value <0.05 was considered statistically significant.
RESULTS
A total of 334 HIV patients were included in this study. The prevalence of anemia, leucopenia, neutropenia, lymphopenia and thrombocytopenia were 37.1%, 22.8%, 8.4%, 10.5% and 17.1% before initiation of HAART and 17.4%, 34.2%, 18.8%, 13.1% and 8.3% after initiation of HAART, respectively. There was a significant difference in total white blood cell (WBC) count, absolute neutrophil count (ANC), red blood cell (RBC) count, hemoglobin value, mean cell volume (MCV), mean cell hemoglobin (MCH), mean cell hemoglobin concentration (MCHC), red cell distribution width (RDW), platelet and CD4+ T cell counts in HIV patients before and after initiation of HAART (P<0.05).
CONCLUSION
The most common hematological abnormalities observed in this study before and after HAART initiation were anemia, leucopenia, neutropenia, lymphopenia, and thrombocytopenia. However, after beginning HAART, the prevalence of anemia and thrombocytopenia decreased dramatically.
背景
血液学异常与人类免疫缺陷病毒（HIV）感染者疾病进展和死亡风险增加相关。抗逆转录病毒药物的使用对血液系统疾病可能产生积极或消极影响。然而，在埃塞俄比亚接受抗逆转录病毒治疗的患者中，尤其是在研究区域，其对血液学参数的影响知之甚少。
方法
2020年9月至11月在德布雷塔博尔综合专科医院进行了一项横断面研究。采用简单随机抽样技术，共选取了334名接受高效抗逆转录病毒治疗（HAART）至少6个月的HIV感染患者。使用半结构化问卷收集研究对象的社会人口学和临床特征。分别使用Sysmex kx - 21血液分析仪和BD FACS count CD4分析仪测定血液学和免疫学参数。使用SPSS 20版统计软件进行统计分析。P值<0.05被认为具有统计学意义。
结果
本研究共纳入334例HIV患者。HAART开始前，贫血、白细胞减少、中性粒细胞减少、淋巴细胞减少和血小板减少的患病率分别为37.1%、22.8%、8.4%、10.5%和17.1%；HAART开始后分别为17.4%、34.2%、18.8%、13.1%和8.3%。HAART开始前后，HIV患者的白细胞总数、绝对中性粒细胞计数、红细胞计数、血红蛋白值、平均红细胞体积、平均红细胞血红蛋白、平均红细胞血红蛋白浓度、红细胞分布宽度、血小板和CD4 + T细胞计数存在显著差异（P<0.05）。
结论
本研究中HAART开始前后观察到的最常见血液学异常为贫血、白细胞减少、中性粒细胞减少、淋巴细胞减少和血小板减少。然而，开始HAART后，贫血和血小板减少的患病率显著下降。
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