Manifestations of Bone Marrow Abnormalities of HIV/AIDS Patients

Abstract

Background: Human immunodeficiency virus can involve almost any organ system. Anemia is themost common hematological manifestation in HIV/AIDS patients. Bone marrow changes includevarying degrees of dysplasia in one or more cell lines, plasmacytosis, opportunistic infections andhematological malignancies. There are only a few studies where hematological manifestations ofHIV/AIDS patients had been described. Materials and Methods: 100 HIV positive patients, agedbetween 12-65 years were enrolled in this hospital-based cross-sectional study. The study wasconducted from March 2016 to March 2018. A complete blood count, CD4 counts were done, besidesa thorough history and clinical examination. HIV positive patients were classified as those havingAIDS and Non-AIDS, according to NACO criteria. Written informed consent was taken from patientsand bone marrow aspiration was done. Results: Total number of patients included in the study was100. We were able to do a CD4 count of 91 patients. As per criteria, out of 91 patients, 37 cases hadAIDS. The most common hematological abnormality was anemia, seen in 95.45%of patients. Bonemarrow was normocellular in 86.48% of AIDS and 85.18% of non-AIDS, hypocellular in 8.10% ofAIDS and 9.25%o f non- AIDS, hypercellular in 5.40% of AIDS and 5.55% of non-AIDS patients.Dysplasia was statistically and significantly associated with anemia. The commonest dysplasticfeatures are seen in the granulocytic and erythroid series. L.D. bodies were seen in 2 cases andHistoplasma was found in one case. Conclusion: Normocytic normochromic anemia was the mostcommon peripheral smear finding. Hypocellular bone marrow was more common than hypercellularmarrow in an advanced stage of the disease. Dysplastic changes were more common in AIDS thanNon-AIDS. Granulocytic dysplasia was the most common type of dysplasia. There was evidence ofopportunistic infections and gelatinous transformation were detected in our study.