HEMATOLOGICAL ABNORMALITIES AND DISEASE PROGRESSION IN HIV-INFECTED PATIENTS: A PROSPECTIVE OBSERVATIONAL STUDY
Main Article Content
Keywords
HIV, AIDS, Hematological abnormalities, Anemia, Thrombocytopenia, WHO staging, Immunodeficiency
Abstract
Background: Acquired Immunodeficiency Syndrome (AIDS), caused by the Human Immunodeficiency Virus (HIV), results in gradual immune system deterioration and predisposes individuals to a variety of hematological abnormalities. These include anemia, leukopenia, neutropenia, thrombocytopenia, and other cytopenias, which are frequently associated with disease progression and CD4 counts. The purpose of this study was to look into the prevalence of hematological abnormalities in HIV-infected people and how they correlated with disease stages, CD4 levels, viral load, and patient outcomes.
Methods: A prospective observational study was carried out at Government Theni Medical College Hospital from October 2021 to September 2022. The study comprised 100 HIV-positive individuals who received a thorough hematological examination, including complete blood counts, CD4 cell counts, and viral load tests. The data were evaluated to determine the distribution of hematological abnormalities at various stages of HIV illness (Stages I-IV) and their relationship to clinical indicators. Statistical analysis was conducted using ANOVA for continuous variables and Chi-square testing for categorical variables, with significance set at p < 0.05.
Results: The study found a high prevalence of anemia, leucopenia, neutropenia, and thrombocytopenia in HIV patients, especially in the late stages of the disease. Anemia was most prevalent in Stage III, with significant gender differences (p < 0.05). Neutropenia and lymphocytopenia were also prevalent in Stage III, with thrombocytopenia following a similar trend. There was a strong association between low CD4 counts and the occurrence of these abnormalities. 86 percent of patients had a CD4 count < 200 cells/µL, indicating severe illness and immunosuppression.
Conclusion: Hematological abnormalities, including anemia, neutropenia, and thrombocytopenia, are frequent in HIV patients and worsen as the disease advances. These anomalies are closely related with low CD4 levels and advanced HIV infection. Monitoring hematological parameters can be an effective approach for monitoring disease progression and directing therapeutic interventions in HIV-positive people.
Methods: A prospective observational study was carried out at Government Theni Medical College Hospital from October 2021 to September 2022. The study comprised 100 HIV-positive individuals who received a thorough hematological examination, including complete blood counts, CD4 cell counts, and viral load tests. The data were evaluated to determine the distribution of hematological abnormalities at various stages of HIV illness (Stages I-IV) and their relationship to clinical indicators. Statistical analysis was conducted using ANOVA for continuous variables and Chi-square testing for categorical variables, with significance set at p < 0.05.
Results: The study found a high prevalence of anemia, leucopenia, neutropenia, and thrombocytopenia in HIV patients, especially in the late stages of the disease. Anemia was most prevalent in Stage III, with significant gender differences (p < 0.05). Neutropenia and lymphocytopenia were also prevalent in Stage III, with thrombocytopenia following a similar trend. There was a strong association between low CD4 counts and the occurrence of these abnormalities. 86 percent of patients had a CD4 count < 200 cells/µL, indicating severe illness and immunosuppression.
Conclusion: Hematological abnormalities, including anemia, neutropenia, and thrombocytopenia, are frequent in HIV patients and worsen as the disease advances. These anomalies are closely related with low CD4 levels and advanced HIV infection. Monitoring hematological parameters can be an effective approach for monitoring disease progression and directing therapeutic interventions in HIV-positive people.
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3. Sehgal S. Unfolding of HIV Epidemic and Spectrum of AIDS in North India. World Journal of AIDS. 2014 Mar 4; 4(01):52-61.
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9. Olu-Taiwo A, Olatunya O, Amusu A, Akanmu A. Red Cell Characteristics in Anaemic HIV Infected Patients. British Journal of Medicine and Medical Research. 2016 Jan 10;15(8):1-7.
10. Antelman G, Spiegelman D, Narh R, Hunter DJ, Fawzi WW, Msamanga GI, Urassa EJ. Nutritional factors and infectious disease contribute to anemia among pregnant women with human immunodeficiency virus in Tanzania. The Journal of nutrition. 2000 Aug 1;130(8):1950-7.
11. Evans RH, Scadden DT. Haematological aspects of HIV infection. Best Practice & Research Clinical Haematology. 2000 Jun 1;13(2):215-30.
12. Van Rhee JA. Hematologic System. Clin. Med. Phys. Assist. 2022 Feb 5;251(1).
13. Pasha I. A Study of Hematologic Manifestations in Patients with Hiv Infection (Doctoral dissertation, Rajiv Gandhi University of Health Sciences (India)).
14. Kaner JD, Thibaud S, Jasra S, Wang Y, Janakiram M, Sharma A, Sridharan A, Elias H, Polineni R, Assal A, Weiss L. HIV portends a poor prognosis in myelodysplastic syndromes. Leukemia & lymphoma. 2019 Dec 6;60(14):3529-35.
15. Kamvuma K, Masenga S, Hamooya B, Chanda W, Munsaka S. Prevalence and factors associated with moderate-to-severe anaemia among virally suppressed people with HIV at a tertiary hospital in Zambia. Plos one. 2024 Aug 26;19(8):e0303734.
16. Cazzola M. Ineffective erythropoiesis and its treatment. Blood, The Journal of the American Society of Hematology. 2022 Apr 21;139(16):2460-70.
17. Lyman GH, Lyman CH, Agboola O, ANC Study Group. Risk models for predicting chemotherapy-induced neutropenia. The oncologist. 2005 Jun 1;10(6):427-37.
18. Zini G. Abnormalities in leukocyte morphology and number. Blood and bone marrow pathology. 2nd ed. Philadelphia: Churchill Livingstone. 2011 Jan 1:247-61.
19. Donadieu J, Fenneteau O, Beaupain B, Mahlaoui N, Chantelot CB. Congenital neutropenia: diagnosis, molecular bases and patient management. Orphanet journal of rare diseases. 2011 Dec;6:1-28.
20. Marionneaux S. Nonmalignant leukocyte disorders. Rodak's Hematology. 2020:445.
21. De Santis GC, Brunetta DM, Vilar FC, Brandao RA, de Albernaz Muniz RZ, de Lima GM, Amorelli-Chacel ME, Covas DT, Machado AA. Hematological abnormalities in HIV-infected patients. International Journal of Infectious Diseases. 2011 Dec 1;15(12):e808-11.
22. Bhardwaj S, Almaeen A, Wani FA, Thirunavukkarasu A. Hematologic derangements in HIV/AIDS patients and their relationship with the CD4 counts: a cross-sectional study. International journal of clinical and experimental pathology. 2020;13(4):756.
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Published
Feb 21, 2025
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How to Cite
Suresh Ramasamy, Thyagarajan N, Saravanan S, Jegatheesh Ramaraj, Gopinath Ramalingam, & Revanth R. (2025). HEMATOLOGICAL ABNORMALITIES AND DISEASE PROGRESSION IN HIV-INFECTED PATIENTS: A PROSPECTIVE OBSERVATIONAL STUDY. Journal of Population Therapeutics and Clinical Pharmacology, 32(1), 1207-1216. https://doi.org/10.53555/ew6k9425
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Author Biographies
Suresh Ramasamy
Assistant Professor, Department of General Medicine, Government Theni Medical College and Hospital, Theni, Tamil Nadu-625512
Thyagarajan N
Assistant Professor, Department of General Medicine, Government Theni Medical College and Hospital, Theni, Tamil Nadu-625512
Saravanan S
Assistant Professor, Department of General Medicine, Government Theni Medical College and Hospital, Theni, Tamil Nadu-625512
Jegatheesh Ramaraj
Assistant Professor, Department of General Medicine, Government Theni Medical College and Hospital, Theni, Tamil Nadu-625512
Gopinath Ramalingam
Scientist B, Department of Microbiology-VRDL, Government Theni Medical College and Hospital, Theni, Tamil Nadu-625512.
Revanth R
Senior Resident, Department of General Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006.
How to Cite
Suresh Ramasamy, Thyagarajan N, Saravanan S, Jegatheesh Ramaraj, Gopinath Ramalingam, & Revanth R. (2025). HEMATOLOGICAL ABNORMALITIES AND DISEASE PROGRESSION IN HIV-INFECTED PATIENTS: A PROSPECTIVE OBSERVATIONAL STUDY. Journal of Population Therapeutics and Clinical Pharmacology, 32(1), 1207-1216. https://doi.org/10.53555/ew6k9425