title: Prevalence of Howell-Jolly body-like inclusions in HIV patients and their correlation with CD4 counts and HIV RNA viral load.
abstract: Previous reports have described the rare occurrence of detached nuclear fragments resembling Howell-Jolly bodies within neutrophils from HIV patients, organ-transplant recipients, and patients on immunosuppressive drugs. To date, their potential clinical significance is unknown, and pathologists tend to disregard their presence. Our study sought to find a correlation between these inclusions and the overall disease state, specifically within the HIV patient population. Eighty-three peripheral smears, all from different patients, were examined for the presence of inclusions and compared with recent CD4 counts and HIV RNA viral loads. Six cases contained inclusions, yielding a prevalence of 7.2%. These six patients had a mean CD4 count of 546±305 cells/μL compared to 247±242 cells/μL in those lacking inclusions (p<0.006) and viral loads of 1,686±3,446 copies/mL compared to 241,882±1,137,229 copies/mL in those lacking inclusions (p=0.6). These findings indicate that the presence of Howell-Jolly body-like inclusions may be viewed as a potential biomarker indicative of a low risk for disease progression and/or good response to therapy based upon higher CD4 counts and relatively favorable viral loads.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA Amer.Wahed@uth.tmc.edu Brian.Chang@uth.tmc.edu.
authors.forename: Brian
authors.initials: B
authors.lastname: Chang
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Richard Sheng Poe
authors.initials: RS
authors.lastname: Huang
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Amitava
authors.initials: A
authors.lastname: Dasgupta
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Nghia
authors.initials: N
authors.lastname: Nguyen
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA Amer.Wahed@uth.tmc.edu Brian.Chang@uth.tmc.edu.
authors.forename: Amer
authors.initials: A
authors.lastname: Wahed
mesh_terms: D018791:CD4 Lymphocyte Count; D004908:Erythrocyte Inclusions / Q000473:pathology*; D015658:HIV Infections / Q000097:blood / Q000276:immunology* / Q000821:virology*; D006801:Humans; D009504:Neutrophils / Q000473:pathology; D012367:RNA, Viral / Q000378:metabolism*; D019562:Viral Load
chemical_list: D012367:RNA, Viral