Profile of blood cell abnormalities among antiretroviral therapy naïve HIV patients attending the Yaounde University Teaching Hospital, Cameroon

Abstract

Background: Abnormal hemograms are common manifestations and important predictive tools for morbidity in the human immunodeficiency virus (HIV) infection. Few studies have been reported on the blood profile of HIV antiretroviral therapy (ART) naive subjects, therefore this study aimed to quantitatively and qualitatively describe the blood cell profile of HIV ART naive patients, and to describe the occurrence of the blood cytopenias by CD4 cell counts and WHO clinical stage. Methods: This cross-sectional study of ART naive HIV patients was done at the Yaounde University Teaching Hospital (YUTH). For eligible participants, a structured questionnaire was filled and a clinical examination was done. Blood samples were collected for the measurement of full blood count and CD4 cell count. Blood films were made for the cytological examination of the blood samples and a reticulocyte count was done by the cresyl blue stain method. Results: Of 81 cases reviewed, 66 (81.5%) had a blood cell disorder. The main qualitative blood disorders on the blood film were metamyelocytes (37.1%), toxic neutrophils (33.3%), stab neutrophils (29.6%), anisocytosis (35.6%) hypochromia (32.1%) and giant platelets (22.2%). Anaemia (62.9%) was the most common quantitative disorder of which 86.3% had low reticulocyte counts. Participants with low CD4 counts and advanced clinical stages had a greater occurrence of blood cytopenias (p-values <0.05). Conclusion: In the HIV infection, peripheral blood cell abnormalities affect all cell lineages, with anaemia being the most frequent single blood cell abnormality. Blood cytopenias mainly occur in advanced immunosuppression and clinical stages. Although all HIV patients may have blood cell disorders, those with advanced disease are more prone to develop them.