The effects of highly active antiretroviral therapy on the haemotological profile of HIV-infected Africans: the Nigerian perspective

Abstract

Background and Objective: This short -term .....se control study of 70 consecutively recruited HIV-infected and previously antiretroviral naive patients, treated with a combination therapy of stavudine, lamivudine and nevirapine (case) and 30 HIV-infected patients who were yet to start therapy (controls) were studied to evaluate the effect of highly active antiretroviral therapy (HAART) on the haematological parameters of HIV infected individuals. Methodology: Haematological parameters of haemoglobin, total with cell count, platelet count, erythrocyte sedimentation rate and differentia/leucocyte count were determined at baseline for subjects and control patients. Subjects were placed on HAART (stavudine 40 mg, lamivudine 150mg and nevirapine 200mg) twice daily for twelve weeks. of haematological parameters was repeated after 12 weeks of HAART in subjects and untreated controls. Result: The occurrence of anaemia, neutropenia, thrombocytopenia and leucopenia obtained respectively at baseline was 84.3%, 24.3%, 11.4% and 11.4% for subjects but after 12 weeks of HAART these declined respectively to 75.7%, 7.1%, 5.7% and 1.4%. Comparatively, there was an increase from baseline values of 96.7%, 23.3%, 6.7% and 6.7% to 100%, 36.7%, 10% and 36.7% respectively in untreated controls. The difference in mean haematological values of subjects and controls at baseline was not statistically significant (p < O.OS). But after 12 weeks of HAART in subjects and observation in untreated controls, the difference in mean haemaglobin (t = 5.77, p < 0.05), platelet count (I= 2.25, p < 0.05) and erythrocyte sedimentation rate (t = -3.20 p < 0.05) became statistically significant. While the haemoglobin, platelet and erythrocyte sedimentation rate improved in subjects, it declined in untreated controls. Conclusion: This study clearly indicates that highly active antiretroviral therapy of two reverse transcriptase inhibitors (stavudine and lamivudine) and one noll -nucleoside reverse transcriptase inhibitor (nevirapine) may improve cytopenios in HIV-infected Nigerians and may be used in patients with haematologic intolerance to other regimen.