Some haematological parameters in human immunodeficiency virus (HIV) infected Africans: the Nigerian perspective.
BACKGROUND
Haematologic abnormalities are among the most common manifestations of advanced human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). A specific diagnosis of cause, severity and mechanism of cytopenia should be sought because of specific treatments or intervention may be indicated for its correction. This study was to determine some haematological parameters in HIV/AIDS infected Nigerians.


METHODS
One hundred HIV/AIDS infected previously antiretroviral naïve adult Nigerians, aged 18-58 year (males 47 and females 53) consisting of 88 symptomatic and 12 asymptomatic patients recruited into the antiretroviral pilot project in the Haematology department of the University of Port Harcourt Teaching Hospital between June 2002 to July 2003 were studied. Haematological parameters of hemoglobin, white cell count, platelet count, erythrocyte sedimentation rate and differential leucocyte count were determined. Data was analyzed using a multipurpose statistical package version 9 SPSS.


RESULTS
The mean haemoglobin was 10.25 +/- 1.97 g/dl (range 6.31-14.2 g/dl), severe anaemia occurred in 80% of subjects while 20% were non-anaemic. Haemoglobin values was found positively correlated to lymphocyte count (r = .319, P = 0.01) and inversely correlated to ESR (r = -.343, P = 0.01) and neutrophil count (r = -.343, P = 0.01). Red cell morphology was variable with majority normochromic and normocytic (64%) and 36% showing hypochromia and anisopoikilocytosis. The mean total WBC count was 4.51 +/- 1.82 x 10(9)/l (range 0.9-8.2 x 10(9)/l). Leucopaenia occurred in 10/100 (10%) of study population. Total white cell count showed a significant inverse correlation to lymphocyte count (r = -.326, P = 0.01). The mean neutrophil count was 2.32 +/- 1.58 x 10(9)/l (range 0.00-5.48). Neutropaenia occurred in 24% of subjects. Neutrophil count showed a significant positive correlation with total white cell count (r = .314, P = 0.01) and a negative correlation with lymphocyte count (r = -.982, P = 0.01). Striking eosinophilia occurred in 3% of subjects. The mean platelet count was 170.07 +/- 49.03 x 10(9)/l (range 72-158 x 268 x 10(9)/l). Thrombocytopaenia occurred in 10/100 (10%) of subjects. The mean erythrocyte sedimentation rate was higher than that in healthy Africans (mean 78.87 +/- 39.33mm fall/hour (range 0.2-158mm fall/hour).


CONCLUSIONS
Observation from this study will serve as a guide to clinicians caring for HIV patients in taking rational decision on haematological complications of HIV infection. This constitutes further evidence of the need for routine monitoring of some haematological parameters of HIV/AIDS infected Africans and before commencement of highly active antiretroviral therapy to ensure that mortality and morbidity are minimized and quality of life optimized.
Erhabor
O
O
Department of Haematology and Blood Transfusion, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
Ejele
O A
OA
Nwauche
C A
CA
Buseri
F I
FI
D015492:AIDS Serodiagnosis / Q000379:methods*; D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D001772:Blood Cell Count; D001799:Blood Sedimentation; D018791:CD4 Lymphocyte Count; D016009:Chi-Square Distribution; D003906:Developing Countries; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D006679:HIV Seropositivity; D006400:Hematocrit; D006403:Hematologic Tests; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D010865:Pilot Projects; D011336:Probability; D011379:Prognosis; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D015996:Survival Rate