What is it about?
In HIV disease progression, there are two important parameters that interplay to predict the progression of HIV to AIDS-defining illness. The duo are "Hematologic indices" and "Immunologic markers". "Hematological indices" in this context are Complete blood count and ESR (CBC/ESR) while the "Immunological marker" is CD4 positive lymphocyte count". This study examined the co relationship of these parameters in prediction of HIV disease progression in resource-limited setting of sub-Saharan Africa. The study population was antiretroviral naive HIV positive subjects from the Niger Delta region of Nigeria.
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Why is it important?
Our findings from this study include the following: 1. Human Immune deficiency virus (HIV) alters the immunological status of an individual, leading to deterioration of the clinical state and hematological indices with disease progression. 2. ESR of HIV positive individuals irrespective of their clinical state (symptomatic or asymptomatic) are usually higher than that of the healthy HIV-negative individuals. 3. Decreased hematological parameters such as hemoglobin concentration (anaemia), absolute lymphocyte count [ALC] (lymphopenia), platelet count (thrombocytopenia) and immunological marker such as CD4 positive lymphocytopenia are useful indicators of HIV disease progression. 4. CD positive lymphocyte count is weakly inversely correlated to ESR in both patients and controls (r= -0.18 & -0.11 respectively), and weakly directly correlated to other haematological indices such as ALC (r= 0.18; 0.24), Haemoglobin concentration (r= 0.07; 0.31), and platelet count (r= 0.05; 0.08)
Perspectives
Although Elevated ESR, decreased Haematocrit, ALC and Platelet count are essential haematologic predictive markers of HIV disease progression, they may not be useful surrogate to CD4 count. However, since investigation facilities determine accreditation for donor driven therapy, there is therefore need to evolve low cost tests (such as hematological tests) in order to access care and treatment of people living with HIV/AIDS in resource limited settings like those found in the Nigeria and other low income countries. My advocacy is to commence Highly active anti-retroviral therapy if hematological tests are done with or without CD4 count tests in such constrained settings, as failure to commence treatment early may lead to emergence of resistant strains or progression to AIDS-defining illnesses.
Dr Ogbonna Collins Nwabuko
Federal Medical Center, Umuahia.
Read the Original
This page is a summary of: The Relationship between Haematologic indices/Immunologic markers and HIV disease in Antiretroviral-naïve HIV seropositive Individuals in the Niger Delta Region of Nigeria., IOSR Journal of Dental and Medical Sciences, January 2013, IOSR Journals,
DOI: 10.9790/0853-0454650.
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