Immuno-hematological Profile Trends of HIV/AIDs Patients on HAART in the South West Region of Cameroon: Retrospective Medical Report Review for Possible Stratified follow-up Pattern in Low Income Settings

摘要

Background: If found with people infected with human immunodeficiency virus (HIV), Immuno-hematological abnormalities can increase the risk of disease progression and death. Inorder to understand the pattern of the immune and hematology cells during Antiretroviral (ARV) therapy, we reviewed and analyse the immune-hematological profiles of HIV patients to determine the possible parameters and patterns that could be used to follow up patients in low income setting where the access of viral load testing is still not affordable. Methodology: A descriptive hospital based cross-sectional study of 285 HIV-1/AIDS adult patients on highly active antiretroviral therapy (HAART) was carried out from January to May, 2015. Review of participants records was also done to obtain baseline and other progressive data. A total of Four groups were created based on the patients duration on HAART. The composition was as follows: Group I (6months - 1year), group II (>1year - 3years), group III (>3years - 5years) and group IV (>5years). After the achieve data was obtain, venous blood was collected, and the number of CD4+ and CD8+ T cells count measured using a flow cytometer. The level of Hemoglobin, number of Platelets, total and differential White Blood Cells were enumerated with automated hematology analyzer. Analyses was carried out to determine changes in various parameters with respect to established baseline values. Results : The pattern for CD4+ T cell at stratified baseline count between < 99 - 499 cells/μl , showed a significant progressive increase from group I to group IV; while CD4+ T cell at stratified baseline count >500 cells/μl had a reversing turn, decreasing gradually among groups II, III and IV, and drastically in group I. The pattern for CD8+ T cell at stratified baseline count between 1000 cells/μl, the pattern decreased gradually from group I to IV, with group II showing a significant decrease. Also hemoglobin baseline level between <7 - 12g/dl, showed a pattern with significant increase among all groups to normal hemoglobin level. With platelets baseline between 400cells/μl showed a reversing turn, with significant decreases to normal level. Furthermore eosinophil baseline at 3%, had a significant decreasing pattern from group I to IV. Leukocytes stratified baseline count at < 4000 cells/ μl had an irregular increasing pattern from group II to IV, then group I and finally group III, while leukocytes stratified baseline count at > 4000 cells/ μl had a similar pattern but reversed in group III and group I. in addition neutrophil at baseline count 40% had an irregular increasing pattern from group II to group III, followed by group I and finally group IV. Conclusion: Group I profile can be used to detect early complications in patients using CD4+ T cell, hemoglobin, platelets, WBC, and neutrophils counts; while CD4+ T cell, hemoglobin, platelets, WBC, neutrophils count and CD8+ T cell baseline of >1000cells/ μL count can be used to monitor the patients’ successful treatment outcome on HAART in group II,III and IV. Starting ARV treatment with a CD4+ T cell of > 500 cells might not be advisable, we equally observed that eosinophils variation is associated with treatment duration. Further studies with larger sample sizes are recommended to make affirmative conclusions.