title: Study of bone marrow changes in antiretroviral naive human immunodeficiency virus-infected anemic patients.
abstract: BACKGROUND
  Bone marrow changes are common throughout the course of HIV infection. There is scanty data addressing this issue in Indian subcontinent. The present study was aimed at characterizing the bone marrow changes in the antiretroviral naive HIV-infected Indian patients with anemia.
  
  
  METHODS
  This was a nonrandomized cross-sectional observational study undertaken over a period of 2 years. Forty-six randomly selected patients with documented anemia served as the study population. None of them was on any antiretroviral therapy or suffering from any known causes of anemia. All the patients underwent thorough evaluation, including bone marrow examination.
  
  
  RESULTS
  Majority of the patients had normocytic-normochromic anemia (63%), in tune with the available data. In most of the cases bone marrow was hypercellular (63.04%), although in a significant proportion it was found to be hypocellular (19.57%). Erythropoiesis was suppressed in 36.96% of patients. Dysplastic changes involving isolated cell lines ranged from 13.04% to 45.65%, dysmegakaryopoiesis being the most common, followed by dyserythropoiesis. Marrow plasmacytosis was detected in 23.91% of patients. No statistically significant correlation was detected in between immunological status (CD4 count) and marrow cellularity, myelodysplastic changes or marrow plasmacytosis. In a fair number of cases bone marrow examination aided in the diagnosis of opportunistic infections.
  
  
  CONCLUSIONS
  Bone marrow changes are common in Indian HIV-infected anemic population, particularly in the advanced stages of the disease. HIV infection should be considered in the differential diagnosis of patients with secondary myelodysplasia or unexplained bone marrow changes.
authors.affiliation: Department of General Medicine, Medical College and Hospital, Kolkata, India. drapande@gmail.com
authors.forename: Arindam
authors.initials: A
authors.lastname: Pande
authors.forename: Maitreyee
authors.initials: M
authors.lastname: Bhattacharyya
authors.forename: Shantasil
authors.initials: S
authors.lastname: Pain
authors.forename: Ajanta
authors.initials: A
authors.lastname: Samanta
mesh_terms: D000328:Adult; D000740:Anemia / Q000453:epidemiology* / Q000209:etiology*; D001853:Bone Marrow / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence