• Humans
• Leukocyte Count/methods
• Leukocyte Count/standards
• Leukopenia/diagnosis
• Leukopenia/blood
• Blood Cell Count/methods
• Chemistry, Clinical/methods
• Leukocytosis/diagnosis
• Leukocytosis/blood
• Leukocytes

• HIV
• indicator
• older
• secondary
• testing

Objectives  Detection of red cell bound immunoglobulins and/or complement by direct antiglobulin test (DAT) is a crucial serological assay in the diagnosis of autoimmune hemolytic anemia (AIHA). However, DAT may be positive in a variety of clinical conditions with or without hemolysis. We aimed at evaluating the clinical and serological correlation of positive DAT by categorizing the clinical conditions associated with positive DAT, estimating the presence of in vivo hemolysis in case of positive DAT with polyspecific and monospecific antisera and correlating the strength of positive DAT with the presence of hemolysis.

Materials and Methods  The prospective observational study was performed on 200 samples that were positive for DAT with polyspecific antiglobulin reagent as the baseline investigation. These samples were further tested with anti-immunoglobulin G and anti-C3 monospecific DAT reagents to evaluate the type of protein responsible for positive DAT. The antiglobulin tests were performed by tube technique. DAT positivity was graded (1+ to 4 + ) in each patient. Autocontrol test was included. The patients with positive polyspecific DAT were categorized into different clinical conditions. The presence or absence of in vivo hemolysis was evaluated in all clinical categories and also for each grade of positivity with polyspecific and monospecific antiglobulin reagents.

Statistical Analysis  Binomial logistic regression and Mann–Whitney U test were applied to between the group analyses. For categorical variables, Fisher's exact test and relative risk were used. The qualitative data were expressed in numbers and percentages.

Results  The highest number of patients (75/200, 37.5%) belonged to the autoimmune diseases group. Tuberculosis and hepatitis C were the main infectious diseases associated with positive DAT. Out of 200 DAT-positive patients, 98 (49%) had in vivo hemolysis and 102 (51%) did not have hemolysis. AIHA (22) and systemic lupus erythematosus (18) were the commonest clinical conditions associated with in vivo hemolysis. All the 11 samples that showed positivity with only anti-C3 reagent did not show any hemolysis. There was statistically significant increase in the incidence of in vivo hemolysis with increasing grades of DAT positivity with all the three antihuman globulin reagents.

Conclusion  There are different disease conditions which show positive DAT with or without hemolysis. So, it is important to clinically and serologically correlate positive DAT results.

• anemia; anti-retroviral therapy; human immunodeficiency virus; prevalence.

• G-CSF
• HIV
• Hck
• IL-17
• Lyn
• Nef
• Src
• iNOS
• myeloid cells

• HIV
• Hematological abnormalities
• adult
• associated factors
• cytopenia
• highly active antiretroviral therapy
• southeast Ethiopia

Globally, anemia is a common hematological disorder among HIV-infected patients. People with anemia often suffer from impaired physical functioning, psychological distress, and poor quality of life. Therefore, the aim of this study was to determine the incidence of anemia and its determinants among HIV positive individuals in northwest Ethiopia.

A total of 486 adult HIV positive patients on the first-line ART with complete information were enrolled in the adult care clinics of northwest Amhara referral hospitals from December 2015 to December 2018. EpiData version 4.2 was used for data entry and Stata version 14 for analysis. Variables having time to event nature were presented with the Kaplan–Meier function. The Cox regression model was used to identify predictors of anemia. Variables with P-values less than 0.2 in the bivariable analysis were considered in the multivariable regression. Adjusted hazard ratio with 95% CI was computed, and variables with less than 0.05 P-values in the multivariable Cox regression were taken as significant predictors of anemia.

This study noted an overall 26.4 per 100 person-year observations (95% CI: 23.46, 30.74) incidence rate of anemia. According to the multivariable Cox regression, TB co-infection (AHR =1.99, 95% CI: 1.45, 2.74), zidovudine-based regimen (AHR=1.39, 95CI: 1.1, 1.85), CD4 level (AHR= 1.7, 95% CI: 1.23, 2.35), advanced WHO stage (AHR=1.32, 95% CI: 1.01, 1.74), and being underweight (AHR= 1.53, 95% CI: 1.14, 2.07) were predictors of anemia.

Anemia is a burden among HIV patients in the study setting. Baseline clinical variables, TB co-infection, and zidovudine-based were predictors of anemia. Therefore, early identification of anemia and addressing significant predictors are highly suggested to the study setting.

• Ethiopia
• HIV
• anemia incidence
• first-line HAART

To measure the prevalence and correlates of abnormal menstruation among women living with HIV (WLWH) in Canada.

We used cross-sectional questionnaire data from the community-based Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS), which enrolled WLWH aged ≥16 from British Columbia (BC), Ontario, and Quebec. For this analysis, we excluded women >45 years, who had primary amenorrhea, were pregnant, on hormonal contraception, or who reported history of endometrial cancer, last menstrual period >12 months ago, or premature ovarian failure. The primary outcome was abnormal menstruation (Yes vs No) based on responses to five questions about menstrual regularity, frequency, volume, duration, and intermenstrual bleeding in the six months prior to interview. An exploratory multivariable logistic regression analysis examined independent correlates of abnormal menstruation.

Of 1422 women enrolled, 521 (37%) met eligibility criteria. Overall, 55.9% (95% CI:52%-60%) reported abnormal menstruation. In adjusted analyses, abnormal menstruation was associated with having a biologic sister/mother who entered menopause before age 40 (AOR 5.01, 95%CI 1.39–18.03), Hepatitis B co-infection (AOR 6.97, 95%CI 1.52–31.88), current smoking (AOR 1.69, 95%CI 1.55–3.41); and currently taking antiretroviral therapy (ART) (AOR 2.36, 95%CI 1.25–4.45) compared to being ART-naïve. Women in BC had higher adjusted odds of abnormal menstruation (AOR 2.95, 95%CI 1.61–5.39), relative to women in Ontario and Quebec.

Over half of WLWH in this analysis had abnormal menstruation. Correlates of abnormal menstruation include genetic, socio-behavioural factors (province of residence, smoking), Hepatitis B co-infection, and current ART use.

• Adolescent
• Adult
• Amenorrhea/epidemiology
• Canada/epidemiology
• Cross-Sectional Studies
• Female
• HIV Infections/complications
• HIV Infections/epidemiology
• Humans
• Menstruation
• Menstruation Disturbances/complications
• Menstruation Disturbances/epidemiology
• Prevalence
• Women's Health
• Young Adult

• MOP111041 CIHR
• CTN 262 CIHR
• Canadian Institutes of Health Research
• Canadian HIV Trials Network, Canadian Institutes of Health Research
• National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (US)
• Academic Health Science Centres (AHSC) Alternative Funding Plans (AFP) Innovation Fund

• HIV-1
• aging
• bone marrow
• extracellular matrix
• lymph node
• thymus

Hematologic abnormalities involving peripheral blood cell cytopenias are strong predictors of morbidity, mortality and poor antiretroviral therapy (ART) outcomes of HIV infected individuals. However, limited studies are conducted in resource-limited settings of sub-Saharan Africa that have addressed the magnitude and associated factors of cytopenias. This study aimed to investigate the magnitude and associated factors of cytopenias among ART naïve HIV infected adult Ethiopians.

A cross-sectional study was conducted among ART naïve HIV infected individuals attending at ART unit of Dessie Referral Hospital between November 01, 2015 and April 30, 2016. A total of 402 adults were included using consecutive sampling. Socio-demographic, clinical and laboratory data of patients were collected. The data were entered to Epi Info version 3.4.3 and analyzed using SPSS version 20 software (SPSS INC, Chicago, IL, USA). Factors associated with cytopenias were analyzed first using bivariate and then multivariate logistic regression models. An odds ratio with 95% confidence interval was used to measure the strength of association. For all statistical significant tests, the cut-off value was set at P<0.05.

In this study, the overall magnitude of any cytopenia, anemia, leucopenia and thrombocytopenia were 63.4%, 43.5%, 24.4% and 18.7%, respectively. In multivariate logistic regression analysis, severe immunosuppression and WHO clinical stage IV HIV disease were significantly associated with increased prevalence of cytopenias. In addition, older age and younger age showed significant association with increased prevalence of anemia and leucopenia, respectively.

Frequent occurrence of cytopenias was independently associated with severe immunosuppression and WHO clinical stage IV HIV disease. Further longitudinal multicenter studies are recommended to bolster the findings of this study in order to suggest the need of routine assessment and management of hematological abnormalities for optimal choice of initial antiretroviral agents and prevention of further morbidities.

• Adolescent
• Adult
• Age Factors
• Aged
• Anemia/chemically induced
• Anemia/epidemiology
• Anti-HIV Agents/adverse effects
• Anti-HIV Agents/therapeutic use
• Blood Cell Count
• Cross-Sectional Studies
• Ethiopia/epidemiology
• Female
• HIV Infections/drug therapy
• Hematologic Diseases/chemically induced
• Hematologic Diseases/epidemiology
• Humans
• Leukopenia/chemically induced
• Leukopenia/epidemiology
• Logistic Models
• Male
• Middle Aged
• Risk Factors
• Thrombocytopenia/chemically induced
• Thrombocytopenia/epidemiology
• Young Adult

Background: Different outcomes of parvovirus B19 (B19V) infection in immunocompromised patients, including HIV1-infected persons, may be life-threatening. Considering the hematologic disorders associated with B19V infection, this study aimed to investigate the prevalence of B19V infection among HIV1-infected individuals in Iran.

Methods: Serum samples from 100 HIV1-infected patients were analyzed for B19 viral DNA using real-time PCR assay. COBAS TaqMan HIV-1 test was performed for quantitative measurements of HIV-1 RNA in the patients’ sera.

Results: Real-time PCR analysis revealed that 10 out of 100 cases (10%) were positive for B19V infection. Across various age groups, the B19V infection was more prevalent among patients within the age range of 21-40 years. Higher prevalence of B19V infection was observed among HIV1-infected patients with a viral load of higher than 400 copies/mL.

Conclusion: Despite limitations, this study may set the stage for further evaluations with larger sample sizes to elucidate the potential role of B19V in hematologic disorders, which may result in exacerbation of the disease in HIV1-infected patients. Moreover, as it has been shown that B19V infection can be treated using intravenous immunoglobulin (IVIG) therapy, available treatments may help improve the quality of life in HIV-infected persons.

• AIDS
• Anemia
• HIV-1
• Parvovirus B19

• Anemia
• CPT
• HAART
• HIV
• Leucopenia
• Lymphopenia
• Thrombocytopenia

• ADP-ribosyl Cyclase 1/genetics
• ADP-ribosyl Cyclase 1/immunology
• Animals
• Antigens, CD34/immunology
• Dendritic Cells/cytology
• Dendritic Cells/immunology
• Dendritic Cells/virology
• HIV Infections/immunology
• HIV Infections/virology
• HIV-1/physiology
• Hematopoiesis
• Hematopoietic Stem Cells/cytology
• Hematopoietic Stem Cells/immunology
• Hematopoietic Stem Cells/virology
• Humans
• Mice
• Mice, Inbred BALB C

• R01 AI077454 NIAID NIH HHS
• R01 AI080432 NIAID NIH HHS
• R01 AI095097 NIAID NIH HHS
• National Science Fund for Outstanding Young Scholars
• UNC University Cancer Research Fund innovation grant
• the National Natural Science Foundation of China
• Sanming Project of Medicine in Shenzhen

• AIDS
• Anaemia
• China
• HIV
• prevalence

• AIDS
• Aspergillus
• HIV
• invasive fungal sinusitis
• opportunistic infection

• T32 AI007613 NIAID NIH HHS
• National Institutes of Health Research Training

• Acute medicine
• Early warning scores
• Frailty
• Outcomes
• Post-discharge surveillance

• Adult
• Aged
• Female
• Follow-Up Studies
• Frail Elderly
• Gait
• Health Resources
• Hospitalization
• Humans
• Length of Stay
• Male
• Middle Aged
• Mortality
• Patient Discharge
• Prognosis
• Severity of Illness Index
• Uganda
• Wakefulness
• Young Adult

• HIV
• Hispanics
• antiretroviral treatment
• blood disorders
• mortality
• pancytopenia
• prevalence

Previous research has reported high rates of anemia in people living with HIV/AIDS (PLWHA) in hospital or tertiary care settings. The objective of this community-based study was to measure the prevalence of anemia and describe the risk factors, with a specific emphasis on HIV symptom burden, in PLWHA in the Kathmandu Valley, Nepal.

We conducted a cross-sectional survey of 319 PLWHA residing in the Kathmandu Valley, Nepal. We recruited participants from five non-governmental organizations in the Kathmandu Valley. Descriptive statistics and multivariable logistic regression analyses were used.

Our study found a 55.8% prevalence of anemia in PLWHA in the Kathmandu Valley. The prevalence of anemia among the participants with first, second, third, and fourth quartiles of HIV symptom burden was 44.8%, 49.3%, 60.3%, and 69.6%, respectively. Compared to the participants with lowest level of HIV symptom burden, the participants with highest level of HIV symptom burden were more likely to have anemia (adjusted odds ratio = 2.14; 95% confidence interval = 1.07 to 4.30).

Due to a high prevalence of anemia in a community-based sample of PLWHA, HIV patients should be counseled on their risk of developing anemia and encouraged to seek timely care for HIV symptoms.

• Adult
• Anemia/epidemiology
• Anemia/virology
• Anti-HIV Agents/therapeutic use
• Cross-Sectional Studies
• Female
• HIV Infections/drug therapy
• HIV Infections/epidemiology
• HIV Infections/etiology
• HIV Seropositivity
• Humans
• Male
• Middle Aged
• Nepal/epidemiology
• Odds Ratio
• Residence Characteristics
• Socioeconomic Factors

• AIDS
• HAART
• granulocytopenia
• myelosuppression
• neutrophil

• AIDS-Related Opportunistic Infections/prevention & control
• Animals
• Anti-Retroviral Agents/therapeutic use
• HIV/immunology
• HIV Infections/complications
• HIV Infections/drug therapy
• HIV Infections/immunology
• Humans
• Neutropenia/etiology
• Neutropenia/prevention & control
• Phagocytosis

• R01 AA019676 NIAAA NIH HHS
• R21 AI106477 NIAID NIH HHS
• R56 AI063944 NIAID NIH HHS
• AA019676 NIAAA NIH HHS

Cytopenias are the most common HIV-associated hematological abnormality. Cytopenias have been associated with several factors including sex, race/ethnicity, geographical location and comorbidities such as tuberculosis, hepatitis B infection, fever and oral candidiasis. Cytopenias become more prevalent as HIV progresses and are often fatal. Data from resource-limited settings about the prevalence and correlates of cytopenia are limited. Therefore we conducted this cross-sectional study to assess the prevalence and correlates of cytopenia among adult AIDS patients at initiation of HAART in Uganda.

400 HIV-infected subjects who were HAART-naïve or on HAART for ≤ 6 months were enrolled into the Multivitamins, HAART and HIV/AIDS Trial. Anemia was defined according to WHO guidelines as any hemoglobin concentration < 12 g/dl for non-pregnant females and < 13 g/dl for males. Leucopenia and thrombocytopenia were defined using study site laboratory reference ranges for lack of generally accepted definitions for these 2 cell lines as leucopenia if white blood cell count < 2.75 × 10⁹ cells/litre and thrombocytopenia if platelets < 125 × 10⁹ cells/litre for females and < 156 × 10⁹ cells/litre for males. Univariate and bivariate analyses were done to describe the patient population and log-binomial regression was used to quantify the correlates of cytopenia.

Sixty five percent of the 400 subjects had at least one form of cytopenia. Anemia occurred in 47.8%, leucopenia in 24.3%, thrombocytopenia in 8.3%, bicytopenia in 21.9% and only 2 had a pancytopenia. Cytopenia was more prevalent in females (prevalence ratio [PR]:1.33, 95% confidence interval [CI]:1.12-1.59); CD4 count category 50 to <200 (PR: 0.75, 95% CI: 0.64 -0.88) and CD4 count category 200 to <350 (PR: 0.74, 95% CI: 0.59 - 0.92) compared to CD4 count category <50; normal BMI (PR: 0.82, 95% CI:0.68-1.00) and overweight BMI (PR: 0.64, 95% CI:0.50- 0.82) compared to underweight BMI and those with a history or presence of oral candidiasis.

Cytopenias are a frequent complication in HIV-infected adults at initiation of HAART in Uganda. The presence of any cytopenia was associated with female sex, decreasing CD4 count and decreasing body mass index. Prospective studies in resource-limited settings on the trend in HIV-related cytopenias are needed.

Hematological abnormalities are common in HIV positive patients. Of these, thrombocytopenia is a known complication which has been associated with progression of disease. However, its magnitude and associated factors in HAART naive HIV positive patients is not known in Ethiopia. Therefore, the aim of this study was to determine the prevalence and associated factors of thrombocytopenia in HAART naïve HIV positive patients.

A retrospective study was carried out among HAART naive HIV positive patients at Gondar University Hospital, Northwest Ethiopia, from September 2011 through August 2012. Socio-demographic variables and immunohematological (platelets and CD4+ T cells) values were carefully reviewed from medical records. Associated factors and outcomes were assessed using logistic regression.

A total of 390 HAART naive HIV positive patients with a mean age of 33.65 years and a range of 18–70 years were reviewed. The overall prevalence of thrombocytopenia was 23(5.9%). The mean CD4 count was 288 ± 188.2 cells/μL. HIV patients whose age ≥ 50 years old were 2.5 times more likely to have thrombocytopenia and those patients whose CD4 count < 350 were 2.6 times more likely to have thrombocytopenia than HIV patients whose CD4 count ≥500. However, CD₄ count was not statistically associated with prevalence of thrombocytopenia (P > 0.05).

As CD4 counts of HIV patients decreasing, they have more likely to have thrombocytopenia. Therefore, early diagnosis and treatment of thrombocytopenia in these patients are necessary.

• Adolescent
• Adult
• Age Factors
• Aged
• Aged, 80 and over
• Anemia/complications
• Anemia/ethnology
• Anemia/pathology
• CD4 Lymphocyte Count
• China/epidemiology
• Cross-Sectional Studies
• Ethnicity
• Female
• HIV Infections/complications
• HIV Infections/ethnology
• HIV Infections/pathology
• Humans
• Logistic Models
• Male
• Middle Aged
• Prevalence
• Risk Factors
• Severity of Illness Index

• Anemia
• art
• clinicoimmunologic stage
• human immunodeficiency virus

Anaemia and thrombocytopenia are haematological disorders that can be detected in many human immunodeficiency virus (HIV)-positive patients during the development of HIV infection. The progressive decline of erythrocytes and platelets plays an important role both in HIV disease progression and in the clinical and therapeutic management of HIV-positive patients. HIV-dependent impairment of the megakaryocyte and erythrocyte lineages is multifactorial and particularly affects survival, proliferation and differentiation of bone marrow (BM) CD34+ haematopoietic progenitor cells, the activity of BM stromal cells and the regulation of cytokine networks. In this review, we analyse the major HIV-related mechanisms that are involved in the genesis and development of the anaemia and thrombocytopenia observed in HIV positive patients.

• Human immunodeficiency virus
• Erythrocytes
• Megakaryocytes
• Haematopoietic progenitor cells
• Virology

• CD4 count
• HIV
• Peripheral blood smear
• Total leucocyte count
• haematological

• Anemia/immunology
• Bone Marrow/virology
• Case-Control Studies
• Child, Preschool
• Erythropoiesis/immunology
• Female
• HIV Infections/complications
• HIV Infections/immunology
• HIV-1
• Humans
• Infant
• Male
• Phylogeny

• 064722 Wellcome Trust

• Acquired Immunodeficiency Syndrome/complications
• Acquired Immunodeficiency Syndrome/drug therapy
• Acquired Immunodeficiency Syndrome/transmission
• Blood Transfusion
• Bone Marrow/pathology
• CD4-Positive T-Lymphocytes/pathology
• Female
• HIV-1
• Hemophilia A
• Homosexuality
• Humans
• Leukocyte Count
• Male
• Substance Abuse, Intravenous
• Thrombocytopenia/complications
• Thrombocytopenia/epidemiology
• Thrombocytopenia/pathology
• Zidovudine/therapeutic use

• Humans
• Purpura, Thrombocytopenic, Idiopathic/diagnosis
• Purpura, Thrombocytopenic, Idiopathic/etiology
• Purpura, Thrombocytopenic, Idiopathic/metabolism
• Purpura, Thrombocytopenic, Idiopathic/physiopathology
• Purpura, Thrombocytopenic, Idiopathic/therapy

• P01 HL040387 NHLBI NIH HHS

• Adult
• Blood Proteins/metabolism
• Bone Marrow/ultrastructure
• Cell Nucleus/pathology
• Endoplasmic Reticulum/ultrastructure
• Erythropoiesis/physiology
• Female
• Granulocytes/ultrastructure
• HIV Infections/pathology
• Hematopoiesis/physiology
• Humans
• Male
• Microscopy, Electron
• Plasma Cells/ultrastructure
• Stem Cells/ultrastructure
• Stromal Cells/pathology
• Vacuoles/ultrastructure