Abstract
BackgroundHematological abnormalities are common in HIV positive patients. Of these, thrombocytopenia is a known complication which has been associated with a variety of bleeding disorders. However, its magnitude and related factors have not been well-characterized in the era of highly active antiretroviral therapy (HAART) in Ethiopia. Therefore, this study aimed to assess the prevalence of thrombocytopenia before and after initiation of HAART among HIV positive patients attending Black Lion Specialized Hospital, Addis Ababa, Ethiopia.MethodsA cross sectional study was conducted from February to April 2017 in Black Lion Specialized Hospital, Addis Ababa, Ethiopia. A total of 176 patients on HAART were selected using simple random sampling techniques. Socio-demographic and clinical characteristics of the study patients were collected using structured questionnaire. Measurements of platelet counts and CD4 + T cell counts were made using Sysmex XT 2000i hematology analyzer and BD FACS Count CD4 analyzer, respectively. Statistical analysis of the data (Paired T- test and binary logistic regression) was done using SPSS version 20. P-value < 0.05 was considered as statistically significant.ResultsA total of 176 patients (Age > 18 years old) were enrolled in this study and had a mean age of 40.08 ± 9.38 years. There was significant increase in the mean values of platelet counts (218.44 ± 106.6 × 103/μl vs 273.65 ± 83.8 × 103/μl, p < 0.001) after six months of HAART initiation compared to the baseline. Prevalence of thrombocytopenia before and after HAART initiation was 25 and 5.7% respectively. HIV patients whose CD4 counts < 200 Cells/μl were more likely to have thrombocytopenia than HIV patients whose CD4 count ≥350 Cells/μl. However, it was not statistically associated with prevalence of thrombocytopenia.ConclusionsThis study has shown that the prevalence of thrombocytopenia after HAART initiation was decreased significantly. Based on our results, a number of study participants still had thrombocytopenia after initiation of HAART. Therefore, continuous screening for thrombocytopenia among HIV infected patients should be performed to decrease the risk of morbidity and mortality.
Highlights
Hematological abnormalities are common in human immunodeficiency virus (HIV) positive patients
This study revealed that the prevalence of thrombocytopenia was 25% at baseline and 5.7% after six months of highly active antiretroviral therapy (HAART) initiation
A study conducted in Uganda reported that the prevalence of thrombocytopenia was 17.8% among antiretroviral HAART-naive and was 13.0% for clients who were on Antiretroviral treatment (ART) for up to 6 months [10]
Summary
Hematological abnormalities are common in HIV positive patients. Of these, thrombocytopenia is a known complication which has been associated with a variety of bleeding disorders. Thrombocytopenia is a frequent hematologic disorder in patients infected with the human immunodeficiency virus (HIV) [1]. It can occur independently of other cytopenias and at all stages of HIV infection [2]. The thrombocytopenia in these patients may be associated with a serious complication including major bleeding and death [3]. It is a frequent disorder occurring in about 30–40% of individuals with HIV infection [4]. The suggested mechanisms that may account for the development thrombocytopenia includes; increased destruction of platelets due to the presence of anti-platelet antibodies, and direct infection of megakaryocytes by HIV leading to low production of platelets from those precursor cells [6]
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