Hematological abnormalities in HIV-antiretroviral therapy naïve clients as seen at an immune suppression syndrome clinic at Mbarara Regional Referral Hospital, southwestern Uganda

Abstract

Crispus Katemba,1 Conrad Muzoora,2 Enoch Muwanguzi,1 Bashir Mwambi,3 Christine Atuhairwe,4 Ivan M Taremwa3 1Department of Medical Laboratory Sciences, Mbarara University of Science and Technology, Mbarara, Uganda; 2Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; 3Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda; 4Institute of Public Health and Management, Clarke International University, Kampala, Uganda Aim/objective: To assess the common hematological abnormalities among HIV-antiretroviral therapy (ART) naïve clients attending an immune suppression syndrome (ISS) clinic at Mbarara Regional Referral Hospital (MRRH), southwestern Uganda. Patients and methods: This was a cross-sectional study carried out during the months of March to August 2016 at the ISS clinic of MRRH. We collected approximately 4.0 mL of EDTA anticoagulated blood samples, which were assayed for complete blood count, CD4+ cell count and thin film examination. Correlation of the hematological abnormalities with CD4+ cell counts was done using correlation coefficient (r) and analysis of variance (F), and the p-value was set at ≤0.05. Results: A total of 141 clients were enrolled. Of these, 67.38% (95/141) were anemic, 26.24% (40/141) had thrombocytopenia while 26.95% (38/141) had leucopenia. Of the 95 participants with anemia, 89.47% (85/95) presented with normocytic-normochromic anemia, 8.42% (8/95) with microcytic-hypochromic anemia and 2.11% (2/95) with macrocytic-hypochromic anemia. Anemia was not different across the several World Health Organization (WHO) stages of HIV infection disease progression (p>0.05). Statistically significant differences were present among participants with leucopenia (p<0.05). Also, leucopenia was more prevalent (11/38) among participants in WHO stage 4 of HIV infection. CD4+ cell counts correlated with thrombocytopenia (r=0.24, p<0.05) and leucopenia (r=0.15, p<0.05). Conclusion: People living with HIV/AIDS (PLWHIV/AIDS) ought to be routinely monitored and treated for the occurrence of hematological abnormalities. Early initiation of ART can help to prevent some hematological abnormalities. Keywords: antiretroviral therapy, HIV, leucopenia, anemia, thrombocytopenia, Uganda

Keywords

• Antiretroviral therapy
• HIV
• leucopenia
• anemia
• thrombocytopenia
• Uganda.