scholarly journals Prevalence of Anemia and Immunological Markers in HIV-Infected Patients on Highly Active Antiretroviral Therapy in Northeastern Nigeria

2013 ◽  
Vol 6 ◽  
pp. IDRT.S10477 ◽  
Author(s):  
Ballah Akawu Denue ◽  
Ibrahim Musa Kida ◽  
Ahmed Hammagabdo ◽  
Ayuba Dayar ◽  
Mohammed Abubakar Sahabi

Background There are conflicting reports on the impact of highly active antiretroviral therapy (HAART) in resolving hematological complications. Whereas some studies have reported improvements in hemoglobin and other hematological parameters resulting in reduction in morbidity and mortality of HIV patients, others have reported no improvement in hematocrit values of HAART-treated HIV patients compared with HAART-naïve patients. Objective This current study was designed to assess the impact of HAART in resolving immunological and hematological complications in HIV patients by comparatively analyzing the results (immunological and hematological) of HAART-naive patients and those on HAART in our environment. Methods A total of 500 patients participated, consisting of 315 HAART-naive (119 males and 196 females) patients and 185 HAART-experienced (67 males and 118 females) patients. Hemoglobin (Hb), CD4+ T-cell count, total white blood count (WBC), lymphocyte percentage, plateletes, and plasma HIV RNA were determined. Results HAART-experienced patients were older than their HAART-naive counterparts. In HAART-naive patients, the incidence of anemia (packed cell volume [PCV] <30%) was 57.5%, leukopenia (WBC < 2.5), 6.1%, and thrombocytopenia < 150, 9.6%; it was, significantly higher compared with their counterparts on HAART (24.3%, 1.7%, and 1.2%, respectively). The use of HAART was not associated with severe anemia. Of HAART-naive patients, 57.5% had a CD4 count < 200 cells/μL in comparison with 20.4% of HAART-experienced patients ( P < 0.001). The mean viral load log10 was significantly higher in HAART-naive than in HAART-experienced patients ( P < 0.001). Total lymphocyte count < 1.0 was a significant predictor of <CD4 counts < 200 cells/μL in HAART-naïve patients, but this relationship was not observed in HAART-experienced patients. Conclusion HAART has the capability of reducing the incidence of anemia, other deranged hematological and immunological parameters associated with disease progression, and death in HIV-infected patients. Total lymphocyte count fails to predict CD4 count < 200 cells/μL in our cohort; thus, its use in the management and monitoring of HIV-infected patients in our settings is not reliable.

2020 ◽  
Vol 9 (1) ◽  
pp. 59
Author(s):  
Iraisa Rosaria

Tujuan: Membuktikan perbedaan jenis pemberian kombinasi Highly Active Antiretroviral Therapy dengan perubahan kadar CD4 dan Total Lymphocyte Count pada pasien HIV/AIDS di RSUP Dr. Kariadi Semarang. Metode: Penelitian ini bersifat analitik yang dilakukan dengan rancangan studi potong lintang. Sampel diambil secara total sampling, yaitu seluruh pasien HIV/ AIDS yang berobat di RSUP Dr. Kariadi Semarang selama 2018 sampai 2019 yang memenuhi kriteria inklusi dan mendapat pengobatan salah satu dari kombinasi Highly Active Antiretroviral Therapy (HAART). Keenam jenis kombinasi HAART tersebut adalah kombinasi I (Efavirens+ Lamivudin+ Tenofovir), II (Evafirenz+ Lamivudin+Zidovudin), III(Nevirapine+ Lamivudin+ Tenofovir), IV (Lamivudine+Zidovudine+Nevirapine), V (Lamivudine+Tenofovir+Rilvipirine), VI (Tenofovir+ Rilvipirine+ Emtricitabine). Data dikumpulkan dari rekam medis pasien dan dianalisis dengan uji Kruskal-Wallis. Hasil:  Dari  89 pasien, didapatkan keenam kombinasi HAART tersebut memberikan efikasi yang baik berdasarkan kenaikan jumlah CD4 dan TLC rerata. Ada perbedaan kenaikan CD4 rerata yang bermakna pada pasien HIV/AIDS antara yang mendapat obat HAART kombinasi I (p  = 0,038), II (p = 0,034), IV (p  = 0,001), V (p  = 0,040), VI (p  = 0,006). Pada Total Lymphocyte Count  (TLC) didapatkan perbedaan kenaikan rerata (p< 0,05) pada  semua  kombinasi HAART. Simpulan: Tidak ada perbedaan jenis pemberian kombinasi Highly Active Antiretroviral Therapy dengan perubahan kadar CD4 dan Total Lymphocyte Count (p> 0,05) pada pasien HIV / AIDS di RSUP Dr. Kariadi Semarang.Kata kunci: CD4, highly active antiretroviral therapy, ODHA, total lymphocyte count


Author(s):  
John Jospeh Diamond Princy ◽  
Kshetrimayum Birendra Singh ◽  
Ningthoujam Biplab ◽  
Ningthoukhongjam Reema ◽  
Rajesh Boini ◽  
...  

Abstract Introduction Human immunodeficiency virus (HIV) infection is a state of profound immunodeficiency. Disorders of hematopoietic system are a common but often overlooked complication of HIV infection. This can manifest at any stage of the disease but more commonly in the advanced stage with low CD4 count. Anemia is the most common hematological abnormality in HIV patients and prevalence ranges from 1.3 to 95%. As HIV disease progresses, the prevalence and severity of anemia also increase. Hence, this study was undertaken to assess the hematological parameters of HIV-infected patients on highly active antiretroviral therapy (HAART) at different treatment durations with the hope to improve the HAART outcome in HIV patients and its correlation with CD4 count. Methods This prospective longitudinal study enrolled 134 HIV-infected patients admitted to or attending the OPD in the Department of Medicine or Antiretroviral Therapy (ART) Center (Center of Excellence), Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, from 2018 to 2020. Complete hemogram, CD4 count, and other related-blood investigations were studied. Results The mean age of the study population was 39.9 ± 11.04 years. Of the 134 patients, 75 (56%) were males and 59 (44%) were females. Twelve (9%) patients had a history of injecting drug use (IDU). TLE (tenofovir, lamivudine, efavirenz) regimen was started on 112 (83.6%) patients and the majority of them (69/134 [51.5%]) had a CD4 count of 200 to 499 cells/mm3, which increased significantly 6 months after HAART to 99 to 1,149 cells/mm3, with a mean of 445 ± 217 cells/mm3. There were significant improvements in hemoglobin (Hb) levels, total leukocyte count (TLC), absolute neutrophil count (ANC), and absolute lymphocyte count (ALC) after HAART indicating a positive correlation with CD4 count (p < 0.05). Thrombocytopenia was observed higher after HAART when compared to baseline. There was a positive correlation between platelet count and CD4 count. However, the mean corpuscular volume (MCV) and erythrocyte sedimentation rate (ESR) had a negative correlation with CD4 count. Conclusion The study inferred a strong positive correlation between CD4 and Hb levels, TLC, ANC, ALC, and platelet count after HAART with improvement in these values as CD4 count increases. Specific treatment intervention based on the changes in the immunohematological profile trends can help prevent most of the adverse effects on HIV patients in our community.


2014 ◽  
Vol 17 (4) ◽  
pp. 570-573 ◽  
Author(s):  
Charles Iheanyichi Emuchay ◽  
Shemaiah Olufemi Okeniyi ◽  
Joshua Olusegun Okeniyi

2021 ◽  
Vol 8 (7) ◽  
pp. 365-368
Author(s):  
Lydia Theresia Tampubolon ◽  
Dharma Lindarto ◽  
Santi Syafril

Background: HIV/AIDS is an immunodeficiency disease with CD4 T lymphocytes as the main target. Although antiretroviral therapy has increased life expectancy of HIV patients, its adverse effect, lipodystrophy, causes a decrease in leptin production by adipose tissue and reduce leptin effect on T lymphocytes’ stimulation. Previous studies had examined the correlation between leptin levels and CD4 count, although the results were inconclusive. This study aims to assess the association between leptin levels and CD4 count in HIV patients receiving HAART. Methods: This is a cross sectional study conducted at the outpatient clinic of Tropical and Infectious Disease Haji Adam Malik General Hospital Medan between April and July 2020. Correlation between variables were assessed through Pearson’s or Spearman’s correlations. Data were analyzed using the SPPS program where p <0.05 was considered significant. Results: A total of 40 HIV patients were analyzed. The mean age of the subjects were 33.62 ± 7.61 years. The mean leptin levels were 1198.97 ± 832.47 ng/mL and the mean CD4 count was 330.55 ± 163.98 cells/mm3. There were no significant differences in leptin levels between HIV stage III and IV (1067.71 ± 902.39 vs. 1090.80 ± 1185.74, p = 0.961). No significant differences were found between CD4 count and HIV clinical stage (392.34 ± 164.70 vs. 339.0 ± 177.46, p = 0.904). There was a significant association between leptin levels and CD4 count in HIV patients receiving HAART (r = 0.351, p = 0.026). Conclusion: Leptin levels were significantly correlated with CD4 count in HIV patients receiving HAART. Keywords: Leptin, CD4 lymphocyte count, HIV, highly active antiretroviral therapy.


BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e015123 ◽  
Author(s):  
Sonia Menon ◽  
Rodolfo Rossi ◽  
Natasha Zdraveska ◽  
Mbabazi Kariisa ◽  
Sushama D Acharya ◽  
...  

ObjectivesIn sub-Saharan Africa, substantial international funding along with evidence-based clinical practice have resulted in an unparalleled scale-up of access to antiretroviral treatment at a higher CD4 count. The role and timing of highly active antiretroviral therapy (HAART) in mediating cervical disease remains unclear. The aim of this article is to systematically review all evidence pertaining to Africa and identify research gaps regarding the epidemiological association between HAART use and the presence of premalignant/malignant cervical lesions.MethodFive databases were searched until January 2017 to retrieve relevant literature from sub-Saharan Africa. Publications were included if they addressed prevalence, incidence or clearance of human papillomavirus (HPV) infection in women undergoing HAART as well as cytological or histological neoplastic abnormalities.Results22 studies were included, of which seven were prospective studies. Women receiving HAART are less likely to develop squamous intraepithelial lesions (SILs). There is evidence that duration of HAART along with the CD4 count may reduce the prevalence of high-risk HPV (HR-HPV), suggesting that without HAART, severe immunosuppression increases the risk of becoming or remaining infected with HR-HPV. Furthermore, according to existent literature, the CD4 count, rather than HAART coverage or its duration, plays a central role in the prevalence of cervical intraepithelial neoplasia (CIN) 2 and CIN 3.ConclusionOur findings suggest a positive impact of HAART duration, in conjunction and interaction with CD4 count, on reducing the prevalence of HR-HPV. The greatest treatment effect might be seen among women starting at the lowest CD4 count, which may have a more instrumental role in cervical oncogenesis than either HAART use or the treatment duration on the prevalence of CIN 2 and CIN 3. There is still insufficient evidence to show a clear association between HAART coverage and the incidence of invasive cervical cancer. Enhanced surveillance on the impact of HAART treatment is crucial.


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