scholarly journals Hematological Profile of HIV-Infected Patients on First-Line Highly Active Antiretroviral Therapy and Its Correlation With CD4 Count

2021 ◽  
Author(s):  
John Jospeh Diamond Princy ◽  
Kshetrimayum Birendra Singh ◽  
Ningthoujam Biplab ◽  
Ningthoukhongjam Reema ◽  
Rajesh Boini ◽  
...  
Keyword(s):  
Platelet Count ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Cd4 Count ◽  
Total Leukocyte Count ◽  
Hiv Patients ◽  
Positive Correlation ◽  
Highly Active ◽  
The Mean

Abstract Introduction Human immunodeficiency virus (HIV) infection is a state of profound immunodeficiency. Disorders of hematopoietic system are a common but often overlooked complication of HIV infection. This can manifest at any stage of the disease but more commonly in the advanced stage with low CD4 count. Anemia is the most common hematological abnormality in HIV patients and prevalence ranges from 1.3 to 95%. As HIV disease progresses, the prevalence and severity of anemia also increase. Hence, this study was undertaken to assess the hematological parameters of HIV-infected patients on highly active antiretroviral therapy (HAART) at different treatment durations with the hope to improve the HAART outcome in HIV patients and its correlation with CD4 count. Methods This prospective longitudinal study enrolled 134 HIV-infected patients admitted to or attending the OPD in the Department of Medicine or Antiretroviral Therapy (ART) Center (Center of Excellence), Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, from 2018 to 2020. Complete hemogram, CD4 count, and other related-blood investigations were studied. Results The mean age of the study population was 39.9 ± 11.04 years. Of the 134 patients, 75 (56%) were males and 59 (44%) were females. Twelve (9%) patients had a history of injecting drug use (IDU). TLE (tenofovir, lamivudine, efavirenz) regimen was started on 112 (83.6%) patients and the majority of them (69/134 [51.5%]) had a CD4 count of 200 to 499 cells/mm3, which increased significantly 6 months after HAART to 99 to 1,149 cells/mm3, with a mean of 445 ± 217 cells/mm3. There were significant improvements in hemoglobin (Hb) levels, total leukocyte count (TLC), absolute neutrophil count (ANC), and absolute lymphocyte count (ALC) after HAART indicating a positive correlation with CD4 count (p < 0.05). Thrombocytopenia was observed higher after HAART when compared to baseline. There was a positive correlation between platelet count and CD4 count. However, the mean corpuscular volume (MCV) and erythrocyte sedimentation rate (ESR) had a negative correlation with CD4 count. Conclusion The study inferred a strong positive correlation between CD4 and Hb levels, TLC, ANC, ALC, and platelet count after HAART with improvement in these values as CD4 count increases. Specific treatment intervention based on the changes in the immunohematological profile trends can help prevent most of the adverse effects on HIV patients in our community.

scholarly journals Correlation between Leptin Levels and CD4 Count in HIV Patients Receiving Highly Active Antiretroviral Therapy (HAART)

2021 ◽  
Vol 8 (7) ◽  
pp. 365-368
Author(s):  
Lydia Theresia Tampubolon ◽  
Dharma Lindarto ◽  
Santi Syafril
Keyword(s):  
Antiretroviral Therapy ◽  
T Lymphocytes ◽  
Highly Active Antiretroviral Therapy ◽  
Clinical Stage ◽  
Cd4 Count ◽  
Hiv Patients ◽  
Keywords Leptin ◽  
Cross Sectional ◽  
Highly Active ◽  
The Mean

Background: HIV/AIDS is an immunodeficiency disease with CD4 T lymphocytes as the main target. Although antiretroviral therapy has increased life expectancy of HIV patients, its adverse effect, lipodystrophy, causes a decrease in leptin production by adipose tissue and reduce leptin effect on T lymphocytes’ stimulation. Previous studies had examined the correlation between leptin levels and CD4 count, although the results were inconclusive. This study aims to assess the association between leptin levels and CD4 count in HIV patients receiving HAART. Methods: This is a cross sectional study conducted at the outpatient clinic of Tropical and Infectious Disease Haji Adam Malik General Hospital Medan between April and July 2020. Correlation between variables were assessed through Pearson’s or Spearman’s correlations. Data were analyzed using the SPPS program where p <0.05 was considered significant. Results: A total of 40 HIV patients were analyzed. The mean age of the subjects were 33.62 ± 7.61 years. The mean leptin levels were 1198.97 ± 832.47 ng/mL and the mean CD4 count was 330.55 ± 163.98 cells/mm3. There were no significant differences in leptin levels between HIV stage III and IV (1067.71 ± 902.39 vs. 1090.80 ± 1185.74, p = 0.961). No significant differences were found between CD4 count and HIV clinical stage (392.34 ± 164.70 vs. 339.0 ± 177.46, p = 0.904). There was a significant association between leptin levels and CD4 count in HIV patients receiving HAART (r = 0.351, p = 0.026). Conclusion: Leptin levels were significantly correlated with CD4 count in HIV patients receiving HAART. Keywords: Leptin, CD4 lymphocyte count, HIV, highly active antiretroviral therapy.

scholarly journals Progressive HIV infection in the presence of a raised CD4+ count: HIV/HTLV-1 co-infection

2013 ◽  
Vol 14 (2) ◽  
pp. 92-94 ◽  
Author(s):  
Ahmad Farid Haeri Mazanderani ◽  
Osman Ebrahim
Keyword(s):  
Immune Deficiency ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Lymphoproliferative Disorders ◽  
Cd4 Count ◽  
Hiv Diagnosis ◽  
Highly Active ◽  
Human T Cell

There are a number of pathophysiological causes for a normal or raised CD4 count in the context of progressive HIV infection. These include various co-infections, previous splenectomy, and lymphoproliferative disorders. Such circumstances can both confound HIV diagnosis and delay initiation of chemoprophylaxis and highly active antiretroviral therapy (HAART). We describe the case of a patient co-infected with HIV and human T-cell lymphotropic virus type 1 (HTLV-1) who, prior to HAART initiation, was found to have progressive immune deficiency associated with a raised CD4 count.

scholarly journals Prevalence and Predictors of Thyroid Dysfunction in Patients with HIV Infection and Acquired Immunodeficiency Syndrome: An Indian Perspective

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Neera Sharma ◽  
Lokesh Kumar Sharma ◽  
Deep Dutta ◽  
Adesh Kisanji Gadpayle ◽  
Atul Anand ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Immune Function ◽  
Highly Active Antiretroviral Therapy ◽  
Thyroid Dysfunction ◽  
Viral Infections ◽  
Disease Onset ◽  
Inverse Correlation ◽  
Cd4 Count ◽  
Highly Active

Background. Predictors of thyroid dysfunction in HIV are not well determined. This study aimed to determine the prevalence and predictors of thyroid dysfunction in HIV infected Indians.Methods. Consecutive HIV patients, 18–70 years of age, without any severe comorbid state, having at least 1-year follow-up at the antiretroviral therapy clinic, underwent clinical assessment and hormone assays.Results. From initially screened 527 patients, 359 patients (61.44±39.42months’ disease duration), having good immune function [CD4 count >200 cell/mm3: 90.25%; highly active antiretroviral therapy (HAART): 88.58%], were analyzed. Subclinical hypothyroidism (ScH) was the commonest thyroid dysfunction (14.76%) followed by sick euthyroid syndrome (SES) (5.29%) and isolated low TSH (3.1%). Anti-TPO antibody (TPOAb) was positive in 3.90%. Baseline CD4 count had inverse correlation with TPOAb after adjusting for age and body mass index. Stepwise linear regression revealed baseline CD4 count, TPOAb, and tuberculosis to be best predictors of ScH after adjusting for age, weight, duration of HIV, and history of opportunistic fungal and viral infections.Conclusion. Burden of thyroid dysfunction in chronic HIV infection with stable immune function is lower compared to pre-HAART era. Thyroid dysfunction is primarily of nonautoimmune origin, predominantly ScH. Severe immunodeficiency at disease onset, TPOAb positivity, and tuberculosis were best predictors of ScH.

Beneficial and Detrimental Effects of Antiretroviral Therapy on HIV-Associated Immunosenescence

Chemotherapy ◽  
2018 ◽  
Vol 63 (2) ◽  
pp. 64-75 ◽  
Author(s):  
Ornella Franzese ◽  
Maria Luisa Barbaccia ◽  
Enzo Bonmassar ◽  
Grazia Graziani
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Highly Active Antiretroviral Therapy ◽  
Immunological Response ◽  
Antiretroviral Drugs ◽  
Hiv Patients ◽  
Progressive Decline ◽  
Highly Active ◽  
Anti Hiv Agents

Since the introduction of highly active antiretroviral therapy more than 2 decades ago, HIV-related deaths have dramatically decreased and HIV infection has become a chronic disease. Due to the inability of antiretroviral drugs to eradicate the virus, treatment of HIV infection requires a systemic lifelong therapy. However, even when successfully treated, HIV patients still show increased incidence of age-associated co-morbidities compared with uninfected individuals. Virus- induced immunosenescence, a process characterized by a progressive decline of immune system function, contributes to the premature ageing observed in HIV patients. Although antiretroviral therapy has significantly improved both the quality and length of patient lives, the life expectancy of treated patients is still shorter compared with that of uninfected individuals. In particular, while antiretroviral therapy can contrast some features of HIV-associated immunosenescence, several anti-HIV agents may themselves contribute to other aspects of immune ageing. Moreover, older HIV patients tend to have a worse immunological response to the antiviral therapy. In this review we will examine the available evidence on the role of antiretroviral therapy in the control of the main features regulating immunosenescence.

scholarly journals Prevalence of Anemia and Immunological Markers in HIV-Infected Patients on Highly Active Antiretroviral Therapy in Northeastern Nigeria

2013 ◽  
Vol 6 ◽  
pp. IDRT.S10477 ◽  
Author(s):  
Ballah Akawu Denue ◽  
Ibrahim Musa Kida ◽  
Ahmed Hammagabdo ◽  
Ayuba Dayar ◽  
Mohammed Abubakar Sahabi
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Lymphocyte Count ◽  
Total Lymphocyte Count ◽  
Cd4 Count ◽  
White Blood Count ◽  
Hiv Patients ◽  
Highly Active ◽  
Total Lymphocyte ◽  
The Impact

Background There are conflicting reports on the impact of highly active antiretroviral therapy (HAART) in resolving hematological complications. Whereas some studies have reported improvements in hemoglobin and other hematological parameters resulting in reduction in morbidity and mortality of HIV patients, others have reported no improvement in hematocrit values of HAART-treated HIV patients compared with HAART-naïve patients. Objective This current study was designed to assess the impact of HAART in resolving immunological and hematological complications in HIV patients by comparatively analyzing the results (immunological and hematological) of HAART-naive patients and those on HAART in our environment. Methods A total of 500 patients participated, consisting of 315 HAART-naive (119 males and 196 females) patients and 185 HAART-experienced (67 males and 118 females) patients. Hemoglobin (Hb), CD4+ T-cell count, total white blood count (WBC), lymphocyte percentage, plateletes, and plasma HIV RNA were determined. Results HAART-experienced patients were older than their HAART-naive counterparts. In HAART-naive patients, the incidence of anemia (packed cell volume [PCV] <30%) was 57.5%, leukopenia (WBC < 2.5), 6.1%, and thrombocytopenia < 150, 9.6%; it was, significantly higher compared with their counterparts on HAART (24.3%, 1.7%, and 1.2%, respectively). The use of HAART was not associated with severe anemia. Of HAART-naive patients, 57.5% had a CD4 count < 200 cells/μL in comparison with 20.4% of HAART-experienced patients ( P < 0.001). The mean viral load log10 was significantly higher in HAART-naive than in HAART-experienced patients ( P < 0.001). Total lymphocyte count < 1.0 was a significant predictor of <CD4 counts < 200 cells/μL in HAART-naïve patients, but this relationship was not observed in HAART-experienced patients. Conclusion HAART has the capability of reducing the incidence of anemia, other deranged hematological and immunological parameters associated with disease progression, and death in HIV-infected patients. Total lymphocyte count fails to predict CD4 count < 200 cells/μL in our cohort; thus, its use in the management and monitoring of HIV-infected patients in our settings is not reliable.

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