Haematological and Immunological Abnormalities in HIV-Infected Adults: A Comparative Study of ART-treated and ART-naive Patients in Kiambu County, Kenya

Abstract

Aims: Globally, haematological and immunological abnormalities in HIV infection are associated with a higher risk of HIV disease progression, morbidity and mortality. This study aim was to assess the magnitude of haematological and immunological abnormalities in ART- treated and ART- naïve HIV infected adult patients and their comparative analysis. Study Design:  Cross – sectional study. Place and Duration of Study: Thika Level Five Hospital Comprehensive Care Centre in Kiambu County, Kenya from July 2022 to December 2023. Methodology: We enrolled 237 participants (122 males and 115 females) which comprised of 106 ART- treated, 51 ART- naïve and 80 HIV Sero-negative controls.  Blood samples were collected using EDTA tubes to prevent clotting. Complete blood count (CBC) was performed using DYMIND DF-52 automated haematology analyser while CD4+ T (Cluster of Differentiation 4) cell counts determined using FACS Calibur system. Sociodemographic information and clinical characteristics were collected by use of a structured questionnaire and review of patient medical records. Comparative analysis was performed using an unpaired T-test with Welch’s correction. Results: Leucopenia was the most prevalent haematological abnormality followed by anemia and thrombocytopenia;18.9%, 15.2% and 2.5% respectively. Prevalence of leucopenia, anemia and thrombocytopenia were higher in ART- treated than in ART- naïve. The mean ± SD of PLT, ALC, HB, MCV, MCH, PCV of ART- treated was significantly higher than mean ± SD of ART- naïve (p <0.05). The mean ± SD CD4 count of ART- treated was higher compared to mean of ART- naïve but not significantly different (p =0.5045). Conclusions: HIV infected patients ought to be routinely monitored for haematological and immunological abnormalities followed by appropriate therapeutic interventions so as to improve quality of life, reduce morbidity and mortality. Kenyan ministry of health should devise new strategies and strengthen the existing programs that encourage earlier HIV testing and treatment so as to reduce the magnitude of the abnormalities in ART- naïve patients.