Retrospective study on HIV/AIDS associated haematological disorders found in bone marrow at Dr George Mukhari Hospital (DGMH), Pretoria

Abstract

Background. Infection with human immunodeficiency virus (HIV) is associated with a range of haematological abnormalities including: ineffective haematopoiesis, infiltrative disease of the bone marrow, nutritional deficiency and peripheral destruction of blood cells secondary to splenomegaly and immune deregulation. Aim. To review and describe bone marrow abnormalities and associated peripheral haematological abnormalities, in HIV/AIDS patients. Methodology. This is a retrospective study. Data was extracted from DISA, the National Laboratory Health Service Laboratory Information System database at the DGMH Tertiary Laboratory from 2003 to 2007. Medical and laboratory records of 80 HIV positive patients who underwent bone marrow examination for investigation of fever and/or cytopenia were reviewed. All statistical analyses were performed on SAS® Release 9.1.3. Results. Twenty-five patients out of a total of 80 (31.25%), had pancytopaenia. Of the 25, eight (32%) were males and 17 (68%) were females. In this study, pancytopaenia was described as a haemoglobin concentration, granulocyte count and platelet count below normal ranges for age and gender. Among male patients in this study, five (17%) patients had TB out of 30. Among female patients, five (10%) out of 50 patients had TB. The majority of patients with malignancies were males six out of nine (67%). Three of the five patients with non-Hodgkin’s lymphoma (NHL) and all of the patients with multiple myeloma (MM) were males. Conclusions. Haematological abnormalities were present in all patients. Bone marrow involvement by TB was found in 12.5% in the study population. Malignancies were more frequent in males; three patients with NHL, two with MM and one with Kaposi sarcoma (KS). The difference in distribution was not statistically significant (p=0.391002). Recommendations. It is recommended that health education and health promotion focus on the control of biological carcinogenic agents such as EBV, HPV and HHV-8 by routinely testing for these agents and by promotion of positive reproductive behaviour among people living with HIV/AIDS. The use of non-invasive tests will be helpful in our setting where there is high TB prevalence.