Geographic Disparities in Haematological and Biochemical Profiles among HIV-Positive Adults on Antiretroviral Therapy across Three Senatorial Districts of Rivers State, Nigeria

Abstract

Background: Routine haematological and biochemical indices support monitoring of adults with HIV, but geographical variation in Rivers State is insufficiently described. Aims: To compare blood count indices, inflammatory cell ratios, biochemical parameters and physical indicators between HIV-positive adults receiving antiretroviral therapy (ART) and healthy controls across three senatorial districts of Rivers State, Nigeria. Study Design: Cross-sectional comparative study. Place and Duration of Study: Nine HIV clinics across Rivers East, Rivers South-East and Rivers West. Methodology: One hundred and twenty-six adults aged 20–45 years were recruited by stratified random sampling: 63 HIV-positive participants receiving ART and 63 controls, with 21 pairs per district. Full blood counts were measured with a Mindray BC-5000 analyser. PLR, NLR, MLR, PMR, NMR, LMR, ENR, SII and SIRI were derived. Serum IFN-γ and IL-10 were quantified by sandwich ELISA. Biochemical and physical indicators were assessed using standard methods. Data were analysed by independent-samples t-tests and one-way ANOVA; p < 0.05 indicated significance. Results: In Rivers East, no haematological parameter differed significantly, although AST was higher (7.70 ± 3.33 vs 4.65 ± 2.88 U/L; p = 0.003) and creatinine lower (0.91 ± 0.24 vs 1.17 ± 0.18 μmol/L; p < 0.001) among HIV-positive participants. In Rivers South-East, white cell, lymphocyte and monocyte counts were lower (p = 0.017, 0.030 and 0.046), while total and conjugated bilirubin were higher (p = 0.048 and 0.027). In Rivers West, these counts were lower (p = 0.044, 0.030 and 0.040), while alkaline phosphatase was higher (p = 0.010). Inter-district variation occurred in eosinophils, mean cell volume, mean cell haemoglobin concentration, PMR, SIRI, alkaline phosphatase, AST, ALT and bicarbonate (p = 0.010–0.034). Conclusion: The findings demonstrate geographical heterogeneity and support evaluation of district-sensitive laboratory monitoring rather than a state-wide approach.