Haematological and biochemistry laboratory abnormalities associated with splenomegaly in asymptomatic adults in Masaka, Uganda: implications for HIV biomedical prevention trials.
OBJECTIVE
To assess the degree of haematological and biochemistry abnormalities associated with splenomegaly in asymptomatic adults in order to determine whether they may be eligible for inclusion in HIV biomedical prevention trials.


METHODS
Asymptomatic adults (50% women) aged 18-60 with splenomegaly (>or=grade II by Hackett's classification) who agreed to provide blood and urine specimens for laboratory testing were invited to participate in a cross-sectional study. Volunteers who were menstruating, pregnant, infected with HIV, syphilis or Hepatitis B and C, or had significant clinical findings were excluded. Haematological and biochemistry laboratory evaluations were performed for enrolled volunteers, and the results were compared to local reference ranges. The proportion of volunteers with out-of-range (OOR) values was estimated for each parameter. Linear regression models were fitted to investigate the association between grade of splenomegaly and laboratory values.


RESULTS
The proportion of volunteers with OOR haematology values ranged from 4.5% (mean corpuscular volume) and 15% (CD4 cells) to 31% (basophils). Increasing spleen size was significantly associated with anaemia, thrombocytopenia and low CD4 count. OOR biochemistry values were found in about 10% of volunteers. Increasing spleen size was associated with reduced creatinine phosphokinase and creatinine (in men) and raised lactate dehydrogenase.


CONCLUSIONS
In areas with a high prevalence of splenomegaly, most asymptomatic individuals with this condition have haematology and biochemistry values that fall within the local reference ranges, and they could therefore be eligible for inclusion in HIV biomedical prevention trials. However, the effect of splenomegaly on certain parameters should be taken into account during interpretation of laboratory-based adverse events.
Ruzagira
Eugene
E
Medical Research Council/Uganda Virus Research Institute Uganda Research Unit on AIDS, Entebbe, Uganda. Eugene.ruzagira@mrcuganda.org
Abaasa
Andrew
A
Levin
Jonathan
J
Bahemuka
Ubaldo
U
Bwanika
Agnes
A
Amornkul
Pauli N
PN
Price
Matthew A
MA
Grosskurth
Heiner
H
Kamali
Anatoli
A
D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000209:etiology; D018791:CD4 Lymphocyte Count; D002986:Clinical Trials as Topic; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012016:Reference Values; D012720:Severity of Illness Index; D013163:Splenomegaly / Q000097:blood* / Q000150:complications / Q000473:pathology; D013921:Thrombocytopenia / Q000209:etiology; D055815:Young Adult