Prevalence of thrombocytopenia before and after initiation of HAART among HIV infected patients at black lion specialized hospital, Addis Ababa, Ethiopia: a cross sectional study

Abstract

BackgroundHematological abnormalities are common in HIV positive patients. Of these, thrombocytopenia is a known complication which has been associated with a variety of bleeding disorders. However, its magnitude and related factors have not been well-characterized in the era of highly active antiretroviral therapy (HAART) in Ethiopia. Therefore, this study aimed to assess the prevalence of thrombocytopenia before and after initiation of HAART among HIV positive patients attending Black Lion Specialized Hospital, Addis Ababa, Ethiopia.MethodsA cross sectional study was conducted from February to April 2017 in Black Lion Specialized Hospital, Addis Ababa, Ethiopia. A total of 176 patients on HAART were selected using simple random sampling techniques. Socio-demographic and clinical characteristics of the study patients were collected using structured questionnaire. Measurements of platelet counts and CD4 + T cell counts were made using Sysmex XT 2000i hematology analyzer and BD FACS Count CD4 analyzer, respectively. Statistical analysis of the data (Paired T- test and binary logistic regression) was done using SPSS version 20. P-value < 0.05 was considered as statistically significant.ResultsA total of 176 patients (Age > 18 years old) were enrolled in this study and had a mean age of 40.08 ± 9.38 years. There was significant increase in the mean values of platelet counts (218.44 ± 106.6 × 103/μl vs 273.65 ± 83.8 × 103/μl, p < 0.001) after six months of HAART initiation compared to the baseline. Prevalence of thrombocytopenia before and after HAART initiation was 25 and 5.7% respectively. HIV patients whose CD4 counts < 200 Cells/μl were more likely to have thrombocytopenia than HIV patients whose CD4 count ≥350 Cells/μl. However, it was not statistically associated with prevalence of thrombocytopenia.ConclusionsThis study has shown that the prevalence of thrombocytopenia after HAART initiation was decreased significantly. Based on our results, a number of study participants still had thrombocytopenia after initiation of HAART. Therefore, continuous screening for thrombocytopenia among HIV infected patients should be performed to decrease the risk of morbidity and mortality.Electronic supplementary materialThe online version of this article (10.1186/s12878-018-0103-6) contains supplementary material, which is available to authorized users.

Prevalence of cytopenia and its associated factors among HIV infected adults on highly active antiretroviral therapy at Mehal Meda Hospital, North Shewa Zone, Ethiopia

“…The difference might be due to variation in the definition of thrombocytopenia, study design and size of the study population. Regarding the severity of thrombocytopenia, the predominant form was mild thrombocytopenia which is consistent with other studies [45,46].…”

“…The possible causes of thrombocytopenia could be immune-mediated platelet destruction, impaired platelet production by the infected magakaryocytes of the bone marrow, or myelosuppression effects of medications. On the other hand, the prevalence of this study was higher than studies done in northwest Ethiopia (4.1% and 6.3%) [15,17], Jimma (6.9%) [19], Addis Ababa (5.7%) [45], and Yaoundé, Cameroon (6.9%) [46], and lower than studies in Ghana (18.5%) [42] and Kaduna State, Nigeria (24%) [26,31]. The difference might be due to variation in the definition of thrombocytopenia, study design and size of the study population.…”

HIV and haematopoiesis

“…There are no published reports available from Frenchspeaking countries in the eastern and southern sub-Saharan African region. These countries include: Ethiopia (10 reports); [6][7][8][9][10][11][12][13][14][15] Malawi (1 report); [16] SA (6 reports); [17][18][19][20][21] Rwanda (1 report); [22] Tanzania (1 report); [23] Uganda (4 reports); [24][25][26][27] and Zimbabwe (1 report). [19] The size of the cohorts ranged from 30 -15 030 patients.…”

“…3) in the treatment-naïve cohorts studied. [7,8,11,12,[21][22][23][24][25][26] Although the prevalence and severity of thrombocytopenia is associated with disease stage, the relationship is not always linear as newly infected patients with HIV may also present with thrombocytopenia. [4] Thrombocytopenia is also more frequently…”

“…Prevalence of cytopenias reported in HIV-infected, treatment-naive cohorts. Scatter dot plot is used to illustrate the percentage ranges reported in 22 (anaemia), [6][7][8][9][10][13][14][15][16][17][18][19][20][21][22][23][24][25][27][28][29][30] 8 (thrombocytopenia) [7,8,11,12,[21][22][23][24][25][26] and 6 (neutropenia) [7,8,19,21,22,25,30]…”