Haematological characteristics of HIV positive patients seen at Muhimbili national hospital and their relation to the clinical stage: a cross-sectional analytical study carried out at Muhimbili national hospital

Background HIV infection in addition to having significant immunologic, infectious and neoplastic manifestations has been reported to be associated with a number of haematological complications which result in significant clinical squealer. The extent of haematological abnormalities in HIV infected patients in Tanzania had not been established. Methods In order to determine the haematological characteristics of HIV positive patients a cross-sectional analytical study was carried out. 196 patients admitted to the medical wards of Muhimbili National Hospital were recruited into the study between 15th of November 2001 to 28th December 2001. The total red and white blood cell counts, red blood cell indices, platelets and ESR were determined in each patient. HIV serostatus was determined in 183 patients. Bone marrow aspiration and examination was carried out in some patients. The differences in haematological characteristics were compared by HIV serostatus, and in those who were HIV positive, by CDC clinical stage. Statistical analysis was carried out using appropriate statistical methods and packages. Findings Patients did not differ much in terms of demographic and physical characteristics. Pulmonary tuberculosis and mucocutaneous fungal infections were found to be significantly higher in those who were HIV positive. The rest of the admitting diagnosis did not differ significantly between HIV positive and HIV negative patients. HIV positive patients were found to have a higher prevalence of blood cytopenias as compared to HIV negative patients. Anaemia, with a prevalence of 71.7% was the most frequent abnormality. The prevalence of Anaemia was shown to increase with advancing clinical stage of HIV infection, but this difference was not statistically significant. The other cytopenias observed were, thrombocytopenia (37.4%), leucopenia (28.6%), and lymphopenia (12.2%). Normochromic-normocytic Anaemia was common in HIV positive patients, as compared to hypochromic-microcytic Anaemia in HIV negative patients, though this difference was not statistically significant. HIV positive patients had lower mean red cell and white cell indices. Logistic regression analysis was done on haematological parameters which differed significantly in those who were HIV positive and HIV negative. Anaemia, lymphopenia and a raised ESR were found to be predictive of HIV positive serostatus. Conclusion Haematological abnormalities were more prevalent in HIV positive patients, with Anaemia being the most prevalent. Anaemia, lymphopenia and a raised ESR were found to be predictive of HIV positive serostatus. These results highlight the existence of these abnormalities in HIV positive patients since they have important clinical implications.