Hematological profile of people living with HIV infection in Government Dharmapuri Medical College, Dharmapuri

Introduction: The HIV epidemic is a convincing illustration of the balance between the power of science and the humanism of modern medicine. The epidemic is so serious that between 1981 and 2000, 21.8 million people had died of HIV/AIDS. Clinically significant hematologic abnormalities are common in HIV infection. These abnormalities may occur as a result of HIV infection itself, as sequelae of HIV related opportunistic infections or malignancies or as a consequence of therapies used for HIV infection and associated conditions. Aim of the Study: To analyzes the hematological profile of people living with HIV/AIDS (PLHA's) and to identify the possible correlation between WHO clinical stage and hematological abnormalities. Materials and methods: All patients with HIV infection attending Govt. Dharmapuri Medical College Hospital, Dharmapuri during the study period were evaluated for the conditions which could alter the Hematological parameters and if found so, they were excluded from the study. Those included in the study were investigated for Hb% total count, differential count, ESR and platelet count. CD4 count done by flow cytometric analysis was obtained. Results: The mean total count was found to be 587+ 2210 cells / mm2 out of the 100 patients 41 of them had leucopenia. In our study the differential count distribution showed neutropenia in 30 patients, lymphocytopenia in 30 patients and monocytopenia in 20 patients. The median CD-4 count was 89 cells/microliter. Almost all the patients enrolled in our study had CD4 count <200/microlitre with only a minor fraction having counts >200/microliter. All patients who had lymphocytopenia were having CD4 count<200/microliter. This establishes the relationship between lymphocytopenia and low CD4 counts. The mean platelet count was 1.56+ 0.35 lakh/mm3 thrombocytopenia was found in 40 patients. The mean value ESR was 24.63 + 10.92 mm /hr. Elevated ESR was found in 71%. ESR has not much of diagnostic value and therefore can be elevated in any chronic inflammation (or) infection. Hence, this finding may not be that significant. Conclusion: Majority of them were in stage III (55%) and had CD4 count <200/microliter (87%). Leucopenia was found in 41% of them. Neutropenia was detected in 29%. Thrombocytopenia was found in 40%. Anemia and elevated ESR detected in 79% and 71% respectively.