Immunohematological Outcome Among Adult HIV Patients Taking Highly Active Antiretroviral Therapy for at Least Six Months in Yabelo Hospital, Borana, Ethiopia

Abstract

Background

Immunohematological abnormalities among human immunodeficiency virus-infected patients are common abnormalities associated with severe depletion of the immune system, covering a stage of acute syndrome to an advanced disease. The greatest impact was observed in the low- and middle-income countries. However, in Ethiopia, little attention has been paid, and only limited published information exists regarding immunohematological abnormalities among individuals receiving highly active antiretroviral treatment.

Objective

This study aimed to assess changes in immunological and hematological parameters in HIV-infected patients receiving HAART for at least six months at the antiretroviral therapy clinic of Yabelo Hospital, Borena, Ethiopia.

Methods

A cross-sectional study was conducted from February to July 2021 using convenient sampling to recruit 333 participants. Sociodemographic data and clinical characteristics were collected using a pretested questionnaire. Baseline data were extracted from medical records and after six month immunohematological measurements were performed on blood samples collected during the study period. Data analysis was performed using SPSS version 25. Descriptive analysis was performed, and the results are presented as numbers and percentages or means ± SD. A paired t-test was used to compare the mean values of the immunohematological parameters before and after six of taking HAART. Statistical significance was set at P < 0.05.

Results

The prevalence of anemia, leucopenia, neutropenia, lymphopenia and thrombocytopenia were 47.4%, 73.3%, 58.3%, 76.9% and 3.3% before initiation of HAART and 23.1%, 36.4%, 23.4%, 35.7% and 2.4% after initiation of HAART, respectively; Compared to baseline, there was also a significant decrease in the rate of Immunosuppression (CD4 < 350) from 62.2% at base line to 20.7% after HAART initiation.

Conclusion

Immunohematological profile of the patients improved after the initiation of HAART. The observation of large proportion of immunosuppressed individuals at baseline warrants advocating for HIV testing in the pastoralist community so that infected patients could benefit from early initiation of HAART.

Keywords:

• HIV
• highly active antiretroviral therapy
• immunohematological abnormalities

Abbreviations

AIDS, Acquired immune deficiency syndrome; AOR, Adjusted odds ratio; ART, Antiretroviral therapy; BMI, Body Mass Index; CBC, Complete blood count; CD4, Cluster of differentiation 4; HAART, Highly active antiretroviral treatment; Hgb, Hemoglobin; HIV, Human immunodeficiency virus; MCH, Mean Corpuscular Hemoglobin; MCHC, Mean Corpuscular Hemoglobin Concentration; MCV, Mean Corpuscular Volume; OI, Opportunistic infection; OR, Odds ratio; PLT, Platelets; RBC, Red blood cell; SD, Standard Deviation; SPSS, Statistical Package for Social Sciences; WBC, White blood cell; YGH, Yabelo general hospital; WHO, World health organization.

Acknowledgments

We would like to thank Addis Ababa University, the study participants and Yabelo General Hospital staff, especially the data collectors and laboratory staff, for their valuable contributions.

Disclosure

The authors declare no conflicts of interest in this work. This paper is based on the thesis by Girma Ashenafi. It has been published on the institutional website: http://etd.aau.edu.et/handle/123456789/28526.