Факторы риска неблагоприятного исхода ВИЧ-инфекции, ассоциированной с цитопенией

Abstract

Introduction. The appearance of hematological abnormalities since the beginning of the HIV-infection epidemic has been associated with an increased risk of disease progression and death in these patients. Aim. Determination of risk factors for an adverse outcome in patients with HIV infection and cytopenia. Materials and methods. Hemograms and myelograms were analyzed in 30 hospitalized patients with HIV infection and cytopenia. All patients had two- or three-lineage cytopenia according to hemogram (anemia and thrombocytopenia, anemia and leukopenia, pancytopenia). Two groups of patients were assigned: in 18 (60%) patients the hospitalization had fatal outcome – group 1 (adverse outcome of the disease); and 12 (40%) patients were discharged from the hospital – group 2 (favorable outcome of the disease). Results. While evaluating the hemograms in patients with HIV infection and cytopenia with different outcomes of the disease, no statistically significant differences were found. Analysis of the bone marrow cellularity showed that the hypocellular and normocellular bone marrow were more often recorded in myelograms of group 1 patients; hypercellular bone marrow was not detected in group 1 patients, in group 2 patients it was determined in 4 cases (33.3%). The cellularity of the erythroid lineage was more often decreased in patients of group 2, normal and increased – in patients of group 1. The granulocyte lineage was more often suppressed in patients of group 1, was normal in patients of group 2, stimulated more often in patients of group 1. The megakaryocyte lineage more often had a decreased cellularity in group 1 patients; normocellularity of the megakaryocyte lineage was in group 2 patients; hypercellularity of the megakaryocyte lineage was not registered in the study groups. When comparing the signs of myelodysplasia in 13 patients of group 1, signs of dyspoiesis were revealed. Conclusion. In patients with HIV infection and cytopenia, as the underlying disease progresses, severe hematological disorders develop, which, in turn, may be risk factors for an adverse outcome of HIV infection.