Hematological Related Disorders and Transfusion of HIV Patients on Highly Active Antiretroviral Therapy (HAART) in the South West Region of Cameroon: Hematological Monitory Parameters for HIV Follow-Up

Abstract

Background: Hematological abnormalities are probably the commonest complications with Human Immuno-deficiency Virus (HIV). Some antiretroviral (ARV) drugs have been documented to have cytopenic effects, in particular when used as a mono-therapy. The use of antiretroviral drugs could positively or negatively affect these parameters, depending on the choice of combination used. Records of transfusion associated with HIV patients during treatment in Cameroon are scarce. Hematological profile is supposed to be properly monitored during treatment with respect to other associated risk factors like duration on Anti-Retroviral Therapy (ART) and adherence to ART, to improve on the care of the patients and prevent further complications like transfusion. Method: A hospital-based descriptive cross-sectional study was conducted from January 2015 to May 2015. A total of 285 HIV-1/AIDS adult patients on Highly Active Antiretroviral Therapy (HAART) for at least 6 months were enrolled in this study. Participants were grouped into four based on, duration on HAART; Group one (6 months-1 year), Group two (>1 year-3 years), Group three (>3 years-5 years) and Group four (>5 years). Venous blood was collected and analysed using an automated hematology analyzer (Hematology analyzer Sysmex KX-21) for the following parameters: hemoglobin, number of platelets, total white blood cells and differential in HIV-1 patients. Results: Of the 285 patients studied, 167 (58.6%) were anemic, among which 52 (18.2%) were from group one; 113 (39.7%) had eosinophilia, among which 33 (11.6%) were from group one; 83 (29.1%) were neutropenic, among which 25 (8.8%) were from group four; 57 (20%) had leucopenia, among which 16 (5.6%) were both from group one and three; 40 (14%) had thrombocytopenia, among which 14 (4.9%) were from group three; 15 (5.3%) had thrombocytosis, among which 6 (2.1%) were from group two; 4 (1.4%) had leukocytosis, among which 2 (0.7%) were from group four; and 3 (1.1%) were neutrophilic. There was a significant statistic difference in hematological disorder among treatment groups (groups one, three and four) only for anemia P<0.05. Among the 285 patients, 22 (7.7%) had been transfused either one or more times during HAART. The prevalence of transfusion with respect to treatment groups were 8 (11%) from group two, followed by 5 (7%) from groups one and three, and lastly 4 (6%) from group four, with a statistically significant association between gender (P<0.001), age (P<0.020) and HAART regimen (P<0.001) with transfusion. Conclusion: There were significant prevalence of anemia, eosinophilia, neutropenia, leucopenia and thrombocytopenia in HIV-1 patients on HAART in the south west region of Cameroon. A close monitoring of hematology abnormalities of these patients on HAART is advised. The transfusion rate after initiation of HAART is common in the south west region of Cameroon, and it is significantly associated with HAART regimen, age and gender.