Red Cell Characteristics in Anaemic HIV Infected Patients

Background: Anaemia is the most frequently encountered haematological complication in human immunodeficiency virus (HIV) infected patients and acquired immunodeficiency syndrome (AIDS) even in the era of highly active anti-retroviral therapy (HAART). Although HAART appears to be associated with a somewhat lower risk of anaemia, anaemia remains common in the HAART era. This study looks at the characteristics of red blood cells in anaemic HIV infected patients with emphasis on red cell indices.

Materials and Methods: A total of 60 patients aged 18-66 years were recruited, comprising of 40 HIV infected, treatment naïve individuals who were also anaemic patients and 20 individuals who were non anaemic patients.

Venous blood (5 mls) was collected by vacutainer from each patient who consented into an anti-coagulant K3 EDTA specimen bottle for haematological indices which included Haemoglobin (Hb), Packed cell volume (PCV), White blood cell (WBC) & differentials, Platelet count and red blood cell indices by automated counter, CD4+ cell count by semi-automated flow cytometer, and HIV viral load was quantitated using PCR- based diagnostic tests. Peripheral blood smear for morphology was done by routine manual methods and stained with Romanowsky stain.

Results: Majority (72.5%) have normocytic anaemia, 10.0% have microcytic anaemia and 17.5% have macrocytic anaemia. Majority (55.0%) of the HIV infected anaemic subjects have normocytic/normochromic red blood cells on morphology.

The mean WBC of HIV infected anaemic patients (7.20 x109/L±4.93) was significantly different from the mean WBC of HIV infected non-anaemic patients (5.66 x109/L±1.74) (p=0.008).

The mean platelet count of HIV infected anaemic patients (277.27 x109/L±126.76) was significantly different from the mean platelet count of HIV infected non-anaemic patients (207.40 x109/L±61.86) (p=0.006).

Conclusion: Anaemia in HIV infection was found to be normocytic normochromic anaemia.