The Effect of Antiretroviral Therapy on Haematological Indicies Among Adults Attending Immunosuppression Clinic at Entebbe General Hospital.

Abstract

Background: Cytopenias are the most common haematological abnormalities among HIV positive patients, a predictor from HIV infection to AIDS. Cytopenias have become more common with the advent of antiretroviral therapy and related treatments for HIV associated infections and malignancies. The use of antiretroviral therapy (ART) for management of patients infected with HIV has had a positive impact on growth, survival, and general wellbeing of children and adults in both resource-rich and resource-poor settings. Data from limited settings like Uganda about the effects of ART on haematological parameters are limited or non-existent in some health settings. Objective: To assess the effects of different ART regimens on hematological indices among adult HIV positive patients attending ISS clinic at Entebbe General Hospital. Methodology and Results: A total of 307 HIV positive adults were enrolled in the study. The mean age of the participants was 33 years with a median age of 31 years. 53.1% (163/307) were married and 46.9% (144/307) single. 37.8% (116/307) were on Septrin prophylaxis while 62.2% (191/307) were on different ART regimens. Cytopenia was common among ART users than Septrin users with granulocytopenia being the most common form at 64.5% (198/307) especially among those on CBV/NVP regimen (37.9%). Thrombocytopenia was 7.5% (23/307) and common among participants on Septrin and CBV/NVP (47.8%) regimen, anaemia was 20.8% (64/307) and common among those on Septrin (33.3%) while 53.1%(163/307) had CD4 counts below 500cells/ml. Conclusion: Cytopenias were common in the study and highly associated with CBV/NVP regimen, which indicated that the regimen was one factor for cytopenia. Therefore constant monitoring of cytopenia and early intervention may decrease the prevalence of cytopenias among HIV positive patients.