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Usman A, Balogun O, Shuaib BI, Musa BOP, Yusuf AA, Ajayi EIO. Prevalence of Cytopenia and its Correlation with Immunosuppression in Naïve HIV-1 Infected Patients Initiating First-Line Antiretroviral Therapy: A Pilot Study. Infect Chemother 2023; 55:479-489. [PMID: 38183393 PMCID: PMC10771947 DOI: 10.3947/ic.2023.0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/17/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND Cytopenias serve as common indicators and crucial predictive tools for evaluating disease progression and therapeutic outcomes in individuals with human immunodeficiency virus (HIV) infection. This study aimed to assess the prevalence of cytopenias and their correlation with the level of immunosuppression in treatment-naive HIV-infected participants after initiating highly active combined antiretroviral drug therapy (cART24). MATERIALS AND METHODS This prospective study focused on evaluating cytopenia in 44 treatment-naive HIV-infected patients who consented to initiate cART and were consecutively enrolled. The research was conducted at the Nasara HIV Treatment & Care Centre of Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, Nigeria, spanning from December 2016 to January 2018. Cytopenias, including anemia, leucopenia, lymphocytopenia, and thrombocytopenia, were defined and assessed according to World Health Organization guidelines. A combination of cross-sectional and longitudinal mixed-design two-step analysis was employed to validate our findings. RESULTS The median time from enrollment to cART initiation was 7 days, following the universal test and treat protocol. The prevalence of cytopenia was 75% at the baseline before treatment and increased to 84% after cART24 administration. There were no statistically significant differences in the median values of immuno-hematological parameters between baseline and after cART24 initiation (P >0.05). In terms of longitudinal assessment, the prevalence of anemia, leucopenia, lymphopenia, and thrombocytopenia at baseline were 66%, 23%, 0%, and 11%, respectively, and after cART24, the rates were 66%, 29%, 5%, and 20%. Notably, the prevalence of cytopenia correlated with declining CD4+ T cell counts. Among instances of unicytopenia, 58% exhibited isolated anemia, 6% had lone leucopenia, and 6% had solitary thrombocytopenia. Additionally, 27% demonstrated bi-cytopenia, and 3% exhibited pancytopenia. Interestingly, none of the study participants presented with lymphopenia. The most common combination was anemia and thrombocytopenia. Both longitudinal and cross-sectional analytical findings were consistent. CONCLUSION In treatment-naive HIV-infected individuals, the prevalence of cytopenias, particularly anemia and thrombocytopenia, was substantial and correlated with the degree of immunosuppression as indicated by CD4+ T cell counts. These cytopenias persisted despite initiation of cART24, highlighting the complexity of hematological manifestations in HIV infection. Our study underscores the significant hematopathological impact of HIV and antiretroviral therapy, highlighting the necessity for preventive strategies to mitigate these adverse effects.
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Affiliation(s)
- Abdulrasheed Usman
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Science Ahmadu Bello University, Zaria, Nigeria.
| | - Olayemi Balogun
- Department of Medical Microbiology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Bukhari Isah Shuaib
- Department of Medical Laboratory Science, Faculty of Applied Health Science Edo State University, Uzairue, Edo State, Nigeria
| | - Bolanle O P Musa
- Immunology Unit, Department of Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Aminu Abba Yusuf
- Department of Haematology, Faculty of Clinical Sciences, Bayero University/Department of Haematology and Blood Transfusion, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Ebenezer I O Ajayi
- DC&ONID, Department of Biochemistry, Faculty of Basic and Applied Sciences, Osun State University, Osogbo, Nigeria
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Lv X, Li P, Yue P, Tang P, Zhou F. Risk factors and prognosis of thrombocytopenia in people living with HIV/AIDS. Ther Adv Hematol 2023; 14:20406207231170513. [PMID: 37223778 PMCID: PMC10201177 DOI: 10.1177/20406207231170513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 04/02/2023] [Indexed: 05/25/2023] Open
Abstract
Background Thrombocytopenia is a common hematological manifestation in people living with human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS; PLWHA). Data on the prognostic relationship and associated factors of thrombocytopenia and HIV infection in China are limited. Objectives We assessed the prevalence of thrombocytopenia, its association with prognosis, and analyzed the associated risk factors among demographic characteristics, comorbidities, hematological and bone marrow indicators. Design We collected patients identified as PLWHA in Zhongnan Hospital. The patients were divided into two groups: the thrombocytopenia group and the non-thrombocytopenia group. We analyzed and compared demographic characteristics, comorbidities, peripheral blood cells, lymphocyte subpopulations, infection indicators, bone marrow cytology, and bone marrow morphology of the two groups. Then we analyzed the risk factors for thrombocytopenia and the effect of platelet (PLT) values on the prognosis of patients. Methods Demographic characteristics and laboratory results were obtained from medical records. In contrast to other studies, we included bone marrow cytology and morphology in this study. Data were analyzed with multivariate logistic regression analysis. The Kaplan-Meier method was used to plot 60-month survival curves for the severe, mild, and non-thrombocytopenia groups. The value p < 0.05 was taken as statistically significant. Results Among 618 identified PLWHA, 510 (82.5%) were male. Overall, thrombocytopenia was found in 37.7% [95% confidence interval (CI): 33.9-41.5%]. Multivariable logistic regression analysis showed that age ⩾40 years [adjusted odds ratio (AOR) 1.869, 95% CI: 1.052-3.320], combined with hepatitis B (AOR 2.004, 95% CI: 1.049-3.826), high procalcitonin (PCT) count (AOR 1.038, 95% CI: 1.000-1.078) were risk factors of thrombocytopenia in PLWHA. An increased percentage of thrombocytogenic megakaryocytes was a protective factor, with an AOR 0.949 (95% CI: 0.930-0.967). Kaplan-Meier survival curve analysis showed that the prognosis was worse in the severe than in the mild (p = 0.002) and non-thrombocytopenia groups (p = 0.008). Conclusion We discovered a general high pervasiveness of thrombocytopenia in PLWHA in China. Age ⩾40 years, combined with hepatitis B virus infection, high PCT, and decreased percentage of thrombocytogenic megakaryocytes indicated a higher risk for developing thrombocytopenia. A PLT count ⩽50 × 109/liter led to a worse prognosis. Therefore, early diagnosis and treatment of thrombocytopenia in these patients are useful.
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Affiliation(s)
- Xiaoyan Lv
- Department of Hematology, Zhongnan Hospital of
Wuhan University, Wuhan, China
| | - Pengpeng Li
- Department of Hematology, Zhongnan Hospital of
Wuhan University, Wuhan, China
| | - Pengpeng Yue
- Zhongnan Hospital of Wuhan University,
Institute of Hepatobiliary Diseases of Wuhan University, Transplant Center
of Wuhan University, National Quality Control Center for Donated Organ
Procurement, Hubei Key Laboratory of Medical Technology on Transplantation,
Hubei Clinical Research Center for Natural Polymer Biological Liver, Hubei
Engineering Center of Natural Polymer-based Medical Materials, Wuhan,
China
| | - Ping Tang
- Department of Hematology, Zhongnan Hospital of
Wuhan University, Wuhan, China
| | - Fuling Zhou
- Department of Hematology, Zhongnan Hospital of
Wuhan University, Wuhan 430071, China
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Mohammed Nuru M, Bizuayehu Wube T, Fenta DA. Magnitude and Factors Associated with Cytopenia Among Children on Highly Active Antiretroviral Therapy at Hawassa University College of Medicine and Health Science, Sidama Region, Southern Ethiopia. HIV/AIDS - RESEARCH AND PALLIATIVE CARE 2023; 15:145-155. [PMID: 37033890 PMCID: PMC10075263 DOI: 10.2147/hiv.s403923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023]
Abstract
Background The most common abnormality in HIV-infected children is cytopenia, a hematological complication characterized by a decline in any of the blood cell lines. It is associated with a higher risk of morbidity and mortality. Therefore, this study aimed to assess the prevalence and associated factors of cytopenia among HIV-positive children on highly active antiretroviral therapy (HAART). Methods Hospital-based cross-sectional study design was conducted on HIV-positive children on HAART from July to September 2020. Socio-demographic and clinical characteristics of the study participants' data were collected using a structured questionnaire. Hematological parameters from the blood sample were analyzed using Ruby Cell-Dyne 300 hematology auto-analyzer. The data were analyzed using SPSS version 20. Logistic regression was used to assess the predictors of cytopenia among the study participants. P-values of less than 0.05 are considered statistically significant. Results Two hundred seventy-three HAART-experienced children were enrolled in this study, and 50.9% were females. At baseline, 40.7% of children were anemic. The overall magnitude of cytopenia among the study participants was 26.7%. The prevalence of anemia, thrombocytopenia, leucopenia and neutropenia among children was 11.4%, 4.0%, 14.3%, and 18.3%, respectively. Patients with an undetectable viral load (AOR = 0.5, CI = 0.3-0.9) are 50% less likely to report cytopenia. HAART-experienced children living in rural areas are more likely to develop cytopenia (AOR = 2.6, CI = 1.3-5.2) than those living in urban areas. Conclusion Hematologic abnormalities are common problems among children on highly active antiretroviral therapy. Therefore, routine investigation of hematological and immunological changes following appropriate therapeutic interventions is recommended.
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Affiliation(s)
- Metsihet Mohammed Nuru
- Comprehensive Specialized Hospital, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
- Correspondence: Metsihet Mohammed Nuru, Tel +2519-39-80-82-06, Email
| | - Temesgen Bizuayehu Wube
- School of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Demissie Assegu Fenta
- School of Medical Laboratory Science, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Xie B, Huang W, Hu Y, Dou Y, Xie L, Zhang Y, Qin S, Lan K, Pang X, Qiu H, Li L, Wei X, Liu Z, Meng Z, Lv J. Anemia and opportunistic infections in hospitalized people living with HIV: a retrospective study. BMC Infect Dis 2022; 22:912. [PMID: 36474196 PMCID: PMC9727975 DOI: 10.1186/s12879-022-07910-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND There is a high prevalence of anemia among people living with HIV in Guangxi, China. Therefore, we investigated anemia and opportunistic infections in hospitalized people living with HIV and explored the risk factors related to anemia in people living with HIV to actively prevent anemia in people living with HIV. METHODS We retrospectively studied people living with HIV admitted to Guangxi Chest Hospital from June 2016 to October 2021. Detailed information on the sociodemographic and clinical features of the participants was collected. The X2 test was used to compare the prevalence between the anemic and non-anemic groups. The logistic regression analysis was applied to exclude confounding factors and identify factors related to anemia. RESULTS Among 5645 patients with HIV, 1525 (27.02%) had anemia. The overall prevalence of mild, moderate, and severe anemia was 4.66%, 14.08%, and 8.27%, respectively. The factors significantly related to increased risk of anemia were CD4 count < 50 cells/µl (aOR = 2.221, 95% CI = [1.775, 2.779]), CD4 count 50-199 cells/µl (aOR = 1.659, 95% CI = [1.327, 2. 073]), female (aOR = 1.644, 95% CI = [1.436, 1.881]) co-infected with HCV (aOR = 1.465, 95% CI = [1.071, 2.002]), PM (aOR = 2.356, 95% CI = [1.950, 2.849]), or TB (aOR = 1.198, 95% CI = [1.053, 1.365]). CONCLUSIONS Within Guangxi of China, 27.02% of hospitalized people living with HIV presented with anemia. Most patients with anemia were in the mild to moderate stage. The low CD4 count, female gender, and concomitant infection with Penicillium marneffei, Hepatitis C virus, or Tuberculosis were independent correlates of anemia. Thus, these findings would be helpful to clinicians in preventing and intervening in anemia in people living with HIV.
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Affiliation(s)
- Bo Xie
- grid.256607.00000 0004 1798 2653School of Information and Management, Guangxi Medical University, Nanning, 530021 Guangxi China
| | - Wei Huang
- Guangxi Clinical Center for AIDS Prevention and Treatment, Chest Hospital of Guangxi Zhuang Autonomous Region, No. 8 Yangjiaoshan Road, Liuzhou, 545005 Guangxi China
| | - Yanling Hu
- grid.256607.00000 0004 1798 2653School of Information and Management, Guangxi Medical University, Nanning, 530021 Guangxi China ,grid.256607.00000 0004 1798 2653Institute of Life Sciences, Guangxi Medical University, Nanning, 530021 Guangxi China ,grid.256607.00000 0004 1798 2653Center for Genomic and Personalized Medicine, Guangxi Key Laboratory for Genomic and Personalized Medicine, Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, 530021 Guangxi China
| | - Yanyun Dou
- Guangxi Clinical Center for AIDS Prevention and Treatment, Chest Hospital of Guangxi Zhuang Autonomous Region, No. 8 Yangjiaoshan Road, Liuzhou, 545005 Guangxi China
| | - Luman Xie
- Guangxi Clinical Center for AIDS Prevention and Treatment, Chest Hospital of Guangxi Zhuang Autonomous Region, No. 8 Yangjiaoshan Road, Liuzhou, 545005 Guangxi China
| | - Yong Zhang
- Guangxi Clinical Center for AIDS Prevention and Treatment, Chest Hospital of Guangxi Zhuang Autonomous Region, No. 8 Yangjiaoshan Road, Liuzhou, 545005 Guangxi China
| | - Shanfang Qin
- Guangxi Clinical Center for AIDS Prevention and Treatment, Chest Hospital of Guangxi Zhuang Autonomous Region, No. 8 Yangjiaoshan Road, Liuzhou, 545005 Guangxi China
| | - Ke Lan
- Guangxi Clinical Center for AIDS Prevention and Treatment, Chest Hospital of Guangxi Zhuang Autonomous Region, No. 8 Yangjiaoshan Road, Liuzhou, 545005 Guangxi China
| | - Xianwu Pang
- grid.256607.00000 0004 1798 2653Center for Genomic and Personalized Medicine, Guangxi Key Laboratory for Genomic and Personalized Medicine, Guangxi Collaborative Innovation Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, 530021 Guangxi China
| | - Hong Qiu
- grid.256607.00000 0004 1798 2653Institute of Life Sciences, Guangxi Medical University, Nanning, 530021 Guangxi China
| | - Lanxiang Li
- grid.256607.00000 0004 1798 2653Basic Medical College of Guangxi Medical University, Nanning, 530021 Guangxi China
| | - Xihua Wei
- grid.256607.00000 0004 1798 2653Institute of Life Sciences, Guangxi Medical University, Nanning, 530021 Guangxi China
| | - Zengjing Liu
- Guangxi Clinical Center for AIDS Prevention and Treatment, Chest Hospital of Guangxi Zhuang Autonomous Region, No. 8 Yangjiaoshan Road, Liuzhou, 545005 Guangxi China
| | - Zhihao Meng
- Guangxi Clinical Center for AIDS Prevention and Treatment, Chest Hospital of Guangxi Zhuang Autonomous Region, No. 8 Yangjiaoshan Road, Liuzhou, 545005 Guangxi China
| | - Jiannan Lv
- Guangxi Clinical Center for AIDS Prevention and Treatment, Chest Hospital of Guangxi Zhuang Autonomous Region, No. 8 Yangjiaoshan Road, Liuzhou, 545005 Guangxi China
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Duguma N, Tesfaye Kiya G, Adissu Maleko W, Bimerew LG. Hematological parameters abnormalities and associated factors in HIV-positive adults before and after highly active antiretroviral treatment in Goba Referral Hospital, southeast Ethiopia: A cross-sectional study. SAGE Open Med 2021; 9:20503121211020175. [PMID: 34104440 PMCID: PMC8165838 DOI: 10.1177/20503121211020175] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/04/2021] [Indexed: 12/20/2022] Open
Abstract
Objectives Hematological abnormalities of the major blood cell lines are frequently reported in patients with HIV-1 infection, in patients without antiretroviral therapy, and during the advanced stages of the disease. Chronic immune activation and inflammation results in the progressive depletion of CD4+ T-cells play a significant role in the clinical progression and pathogenesis of this infection. This study was aimed at assessing the prevalence of hematological abnormalities and their associated factors before and after the initiation of antiretroviral therapy in adults with HIV-1 infection in a referral hospital. Methods The study was conducted from 1 April to 30 June 2018, at Goba Referral Hospital. A total of 308 HIV-positive adults on treatment were enrolled during the study period. Socio-demographic and clinical data were collected using a structured questionnaire, with pre-highly active antiretroviral therapy data were extracted from medical records while post-treatment immuno-hematological measurements were done on blood samples collected at the time of enrollment. Results The prevalence of anemia, leukopenia, and thrombocytopenia before initiation of antiretroviral treatment was higher, although anemia and thrombocytopenia decreased correspondingly after initiation of treatment leukopenia increased by 4%. Mean values of immuno-hematological parameters before and after treatment initiation were significant (p < 0.05). CD4+ T-cell count <200 cells/µL was the only independent risk factor for anemia and leukopenia before highly active antiretroviral therapy, while stage IV disease, female sex, zidovudine, lamivudine, and nevirapine treatment, and intestinal parasite infection were predictors of anemia after treatment initiation. Conclusion The study revealed that hematological abnormalities are common in HIV infection, while the occurrence of abnormalities after highly active antiretroviral therapy initiation. Different risk factors are associated with hematological abnormalities at pre- and post-highly active antiretroviral therapy with regular monitoring of risk factors, adherence to the early initiation of highly active antiretroviral therapy, and conduct of further longitudinal studies are recommended.
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Affiliation(s)
- Negesso Duguma
- Department of Medical Laboratory Sciences, Madda Walabu University, Goba, Ethiopia
| | - Girum Tesfaye Kiya
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Wondimagegn Adissu Maleko
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia.,Clinical Trial Unit, Jimma University, Jimma, Ethiopia
| | - Lealem Gedefaw Bimerew
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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Nka AD, Sosso SM, Fokam J, Bouba Y, Teto G, Simo Rachel R, Tiga A, Yimga J, Nukenine EN, Nanfack AJ, Takou D, Aroga Z, Colizzi V, Ndjolo A. Thrombocytopenia according to antiretroviral drug combinations, viremia and CD4 lymphocytes among HIV-infected patients in Cameroon: a snapshot from the City of Yaoundé. BMC Res Notes 2019; 12:632. [PMID: 31554515 PMCID: PMC6761711 DOI: 10.1186/s13104-019-4664-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 09/18/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Thrombocytopenia is an abnormal decrease in blood platelets, which can affect the prognosis of people living with HIV (PLHIV). In order to assess the burden of this haematological disorder, we evaluated the frequency of thrombocytopenia according to antiretroviral drug combinations, viremia and the immune status of PLHIV. RESULTS A cross-sectional and analytical study was conducted from June to November 2016 among 310 PLHIV at the "Chantal BIYA" International Reference Centre, Yaoundé, Cameroon. Overall rate of thrombocytopenia was 19.0% (59/310). The rate of thrombocytopenia was 64.6% (42/65) versus 6.9% (17/245) in ART-naïve versus ART-treated patients respectively, p < 0.0001. Following viral load, rate of thrombocytopenia was 15.8% (20/130) in those with undetectable viral load, and 34.1% (27/79) with viral loads > 3 log10 RNA/ml (p = 0.03). As concerns CD4-count, rate of thrombocytopenia was 16.2% (42/259) in those with ≥ 200 CD4/mm3 versus 33.3% (17/51) with < 200 CD4/mm3 (p = 0.0003). After adjusting for sex, ART, viral load and CD4, Viral load and ART exposure were significantly associated with decreased risk of thrombocytopenia (p < 0.05). Thrombocytopenia occurs especially among ART-naïve, high viremia and severe immune-compromised patients. Interestingly, ART coverage appears as an independent factor in preventing the occurrence of thrombocytopenia.
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Affiliation(s)
- Alex Durand Nka
- “Chantal BIYA” International Reference Centre for Research on HIV/AIDS Prevention and Management, (CIRCB), Yaoundé, Cameroon
- Faculty of Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Samuel Martin Sosso
- “Chantal BIYA” International Reference Centre for Research on HIV/AIDS Prevention and Management, (CIRCB), Yaoundé, Cameroon
| | - Joseph Fokam
- “Chantal BIYA” International Reference Centre for Research on HIV/AIDS Prevention and Management, (CIRCB), Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Yagai Bouba
- “Chantal BIYA” International Reference Centre for Research on HIV/AIDS Prevention and Management, (CIRCB), Yaoundé, Cameroon
| | - Georges Teto
- “Chantal BIYA” International Reference Centre for Research on HIV/AIDS Prevention and Management, (CIRCB), Yaoundé, Cameroon
| | - Rachel Simo Rachel
- “Chantal BIYA” International Reference Centre for Research on HIV/AIDS Prevention and Management, (CIRCB), Yaoundé, Cameroon
| | - Aline Tiga
- “Chantal BIYA” International Reference Centre for Research on HIV/AIDS Prevention and Management, (CIRCB), Yaoundé, Cameroon
| | - Junie Yimga
- “Chantal BIYA” International Reference Centre for Research on HIV/AIDS Prevention and Management, (CIRCB), Yaoundé, Cameroon
| | | | - Aubin Joseph Nanfack
- “Chantal BIYA” International Reference Centre for Research on HIV/AIDS Prevention and Management, (CIRCB), Yaoundé, Cameroon
| | - Désiré Takou
- “Chantal BIYA” International Reference Centre for Research on HIV/AIDS Prevention and Management, (CIRCB), Yaoundé, Cameroon
| | | | - Vittorio Colizzi
- “Chantal BIYA” International Reference Centre for Research on HIV/AIDS Prevention and Management, (CIRCB), Yaoundé, Cameroon
- University of Rome “Tor Vergata”, Rome, Italy
| | - Alexis Ndjolo
- “Chantal BIYA” International Reference Centre for Research on HIV/AIDS Prevention and Management, (CIRCB), Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
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Tamir Z, Seid A, Haileslassie H. Magnitude and associated factors of cytopenias among antiretroviral therapy naïve Human Immunodeficiency Virus infected adults in Dessie, Northeast Ethiopia. PLoS One 2019; 14:e0211708. [PMID: 30759131 PMCID: PMC6373930 DOI: 10.1371/journal.pone.0211708] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 01/18/2019] [Indexed: 12/31/2022] Open
Abstract
Background Hematologic abnormalities involving peripheral blood cell cytopenias are strong predictors of morbidity, mortality and poor antiretroviral therapy (ART) outcomes of HIV infected individuals. However, limited studies are conducted in resource-limited settings of sub-Saharan Africa that have addressed the magnitude and associated factors of cytopenias. This study aimed to investigate the magnitude and associated factors of cytopenias among ART naïve HIV infected adult Ethiopians. Materials and methods A cross-sectional study was conducted among ART naïve HIV infected individuals attending at ART unit of Dessie Referral Hospital between November 01, 2015 and April 30, 2016. A total of 402 adults were included using consecutive sampling. Socio-demographic, clinical and laboratory data of patients were collected. The data were entered to Epi Info version 3.4.3 and analyzed using SPSS version 20 software (SPSS INC, Chicago, IL, USA). Factors associated with cytopenias were analyzed first using bivariate and then multivariate logistic regression models. An odds ratio with 95% confidence interval was used to measure the strength of association. For all statistical significant tests, the cut-off value was set at P<0.05. Results In this study, the overall magnitude of any cytopenia, anemia, leucopenia and thrombocytopenia were 63.4%, 43.5%, 24.4% and 18.7%, respectively. In multivariate logistic regression analysis, severe immunosuppression and WHO clinical stage IV HIV disease were significantly associated with increased prevalence of cytopenias. In addition, older age and younger age showed significant association with increased prevalence of anemia and leucopenia, respectively. Conclusion Frequent occurrence of cytopenias was independently associated with severe immunosuppression and WHO clinical stage IV HIV disease. Further longitudinal multicenter studies are recommended to bolster the findings of this study in order to suggest the need of routine assessment and management of hematological abnormalities for optimal choice of initial antiretroviral agents and prevention of further morbidities.
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Affiliation(s)
- Zemenu Tamir
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- * E-mail:
| | - Abdurahaman Seid
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Haftay Haileslassie
- Department of Medical Laboratory Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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Effect of Zhen Qi Fu Zheng granules on the bone marrow depression model induced by Zidorf. Saudi J Biol Sci 2018; 25:220-225. [PMID: 29472768 PMCID: PMC5816002 DOI: 10.1016/j.sjbs.2017.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 09/25/2017] [Accepted: 10/01/2017] [Indexed: 11/23/2022] Open
Abstract
Zidorf is a commonly used drug for the treatment of AIDS, the most common side effects of AZT was bone marrow depression. Therefore, we investigated the effects of Zhen Qi Fu Zheng (AQFZ) granules on the model of bone marrow depression induced by AZT. We showed that the high, medium and low doses of AQFZ granules could increase the number of WBC in the mice model induced by AZT, and the difference was significant (P < 0.01) compared with the model group. Each dose of AQFZ granules can increase the thymus cortex thickness, the number of thymus lymphocytes, spleen nodule size, the number of lymphocytes in the spleen (P < 0.01). The medium dose of AQFZ granules can also significantly improve the number of BMC in the bone marrow depression model (P < 0.01). As well as, the low dose of AQFZ granules can clearly increase the number of nucleated cells in a bone marrow (P < 0.05) and IL-2blood serum. So, AQFZ granules can improve and regulate the hemogram, bone marrow and immune level of bone marrow depression model induced by AZT.
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Yao KH, Tanon AK, Lagou AD, Konan SD, Diopoh SP, Meite F. [Comparative study of community acute kidney injury in HIV infected versus non-infected persons: Experience of an internal medicine department in Abidjan (Côte d'Ivoire)]. Nephrol Ther 2017; 13:168-175. [PMID: 28462877 DOI: 10.1016/j.nephro.2016.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 08/23/2016] [Accepted: 10/03/2016] [Indexed: 01/30/2023]
Abstract
BACKGROUND Acute kidney injury (AKI) is commonly associated with HIV infection. OBJECTIVES To describe the profile of AKI in HIV infected versus non-infected persons. PATIENTS AND METHODS This is a prospective study that was carried out during the study period from January 2010 to December 2015 in the department of nephrology-internal medicine D of Treichville University Hospital (Côte d'Ivoire). RESULTS The prevalence of HIV infection was 35.2% in the population of AKI. The average age of patients was 42±18 years in the HIV positive group against 51±18 years in the HIV negative group (P=0.0001). Etiologies were infections in 65.1% in the HIV positive group against 38.8% in the HIV negative group (P=0.0001) and water loss in 24.7% in the HIV positive group against 7.8% in the HIV negative group (P=0.0001). Factors such as the AIDS stage (P=0.002), severe sepsis (P=0.002) and acute pyelonephritis (P=0.001) were associated with mortality in HIV positive patients against severe anemia (P=0.0001) and severe sepsis (P=0.0001) in the HIV-negative group. CONCLUSION HIV positive patients are younger with a female predominance. The mortality rate is identical in both groups.
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Affiliation(s)
- Kouamé Hubert Yao
- Service de néphrologie-médecine interne, CHU Treichville, BP V3 Abidjan 01, Abidjan, Cote d'Ivoire.
| | - Aristophane Koffi Tanon
- Service des maladies infectieuses et tropicales, CHU Treichville, BP V3 Abidjan 01, Abidjan, Cote d'Ivoire
| | | | - Serge Didier Konan
- Service de néphrologie-médecine interne, CHU Treichville, BP V3 Abidjan 01, Abidjan, Cote d'Ivoire
| | - Séry Patrick Diopoh
- Service de néphrologie-médecine interne, CHU Treichville, BP V3 Abidjan 01, Abidjan, Cote d'Ivoire
| | - Fatou Meite
- Service de néphrologie-médecine interne, CHU Treichville, BP V3 Abidjan 01, Abidjan, Cote d'Ivoire
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Kutty RK, Peethambaran AK, Sunilkumar, Anilkumar M. Conservative Treatment of Chronic Subdural Hematoma in HIV-Associated Thrombocytopenia with Tranexamic Acid. J Int Assoc Provid AIDS Care 2016; 16:211-214. [PMID: 27909114 DOI: 10.1177/2325957416680294] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Chronic subdural hematomas (CSDHs) and its management comprise a majority work in a neurosurgical specialty. The effectiveness of surgery is beyond doubt and sometimes even lifesaving in severe cases. However, the straightforward surgery is sometimes complicated by the associated comorbidities of the patient. Comorbidities in the form of coagulopathies secondary to chronic liver diseases, drugs (warfarin, ecosprin, clopidogrel), thrombocytopenia secondary to systemic illness are always a challenge to deal with in patients with CSDH. The authors encountered a patient with thrombocytopenia secondary to systemic HIV infection who presented with CSDH. Her coagulation profile was severe enough to preclude surgery. She was managed conservatively with tranexamic acid and responded well. The authors present the challenges they faced in the course of successful management of this patient.
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Affiliation(s)
- Raja K Kutty
- 1 Department of Neurosurgery, Government Medical College, Trivandrum, Kerala, India
| | | | - Sunilkumar
- 1 Department of Neurosurgery, Government Medical College, Trivandrum, Kerala, India
| | - M Anilkumar
- 1 Department of Neurosurgery, Government Medical College, Trivandrum, Kerala, India
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11
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Shen Y, Wang J, Wang Z, Shen J, Tangkai Qi, Song W, Tang Y, Liu L, Zhang R, Zeng Y, Lu H. A cross-sectional study of leukopenia and thrombocytopenia among Chinese adults with newly diagnosed HIV/AIDS. Biosci Trends 2016; 9:91-6. [PMID: 26173294 DOI: 10.5582/bst.2015.01024] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We conducted a cross-sectional study to determine the prevalence and risk factors of leukopenia and thrombocytopenia among Chinese adults with newly diagnosed HIV/AIDS. One thousand nine hundred and forty-eight newly diagnosed HIV-infected patients were enrolled between 2009 and 2010. Serum samples obtained from each individual were collected for complete blood count. Factors associated with the presence of leukopenia and thrombocytopenia were analyzed by multiple logistic regression. The overall prevalence of leukopenia and of thrombocytopenia was 33.2% and 15.6%, respectively. The prevalence of leukopenia was higher among females than among males (39.4% versus 31.2%). The prevalence of leukopenia increased with decreasing CD4 count (8.2%, 26.5%, 33.4%, and 41.5% among patients with CD4 count of ≥ 350, 200-349, 50-199, and < 50 cells/mm3 respectively). The prevalence of thrombocytopenia also showed an increasing trend with decreasing CD4 count (5.8%, 12.2%, 17.8%, and 17.5% among patients with CD4 count of ≥ 350, 200-349, 50-199, and < 50 cells/mm3, respectively). Logistic analysis showed that female sex, lower CD4 count, and Han ethnicity were significantly associated with an increased risk of leukopenia, and that lower CD4 count, and HIV transmission by blood were significantly associated with an increased risk of thrombocytopenia. The study reflects that leukopenia and thrombocytopenia are common among Chinese adults with newly diagnosed HIV/AIDS; and lower CD4 count is associated with an increased risk of both leukopenia and thrombocytopenia. We propose that a routine assessment of these parameters is necessary for timely and adequate clinical management.
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