Hematological Abnormalities in Early and Advanced HIV Infection Patients

Background: Hematological abnormalities in patients with HIV infection are common. These hematological abnormalities include anemia, leukopenia, thrombocytopenia, and sometimes pancytopenia with variable bone marrow abnormalities. Methodology: A study was conducted from March 2008 to April 2010 in a tertiary care center-JSS Hospital, Mysore, Karnataka. The patients admitted to the Department of Medicine and Dermatology wards with the diagnosis of HIV infection as per standard WHO criteria were included in the study. A detailed history, physical examination, and relevant investigations were conducted. Data were collected using a pre-tested proforma to meet the objectives of the study. Results: A total of 100 HIV-positive patients were included in the study and were assigned into either Groups A and B. Group A patients included HIV-positive patients with CD4 counts >200 cells/cumm, and Group B included HIV-positive patients with CD4 counts <200 cells/cumm. 50 patients were included in each group. Most of these patients (about 60%) were in the highly reproductive age group (21-40 years) and were predominantly males (78%). The common symptoms among these patients were fever (79%), weight loss (64%), and oral thrush (24%). Anemia was the most common laboratory abnormality seen in both the groups with 70% in Group A and 84% in Group B. Leukopenia was seen in 10% of patients in Group A and 60% of patients in Group B. Thrombocytopenia was seen in 32% cases among Group A and 78% cases among Group B. Conclusion: In patients with HIV infection, the frequency and severity of hematological manifestations including hypocellular bone marrow increased with the decline in CD4 counts. This might lead to a significant impact on clinical outcome and patient's quality of life. Hence, all the HIV patients should also be investigated for hematological abnormalities and treated accordingly.