Role of Hematological and Alternate Markers in Human Immunodeficiency Virus Disease Progression

Problem statement: The knowledge of HIV infection has expanded tremendously which has led to significant improvement in the treatment, leading to decrease in morbidity and mortality. Considering the limitations in using CD4+T-cell counts and HIV RNA viral load as markers in the HIV disease progression, physicians treating the HIV patients now look for alternate markers that predict HIV disease progression and help in initiating and monitoring the Antiretroviral Treatment (ART). Approach: Blood samples were collected from 120 HIV sero-positive, antiretroviral therapy naive patients attending the Integrated Counseling and Testing Centre (ICTC) of Kamineni Institute of Medical Sciences, Narketpally, Nalgonda. The study was carried out between January 2007 and June 2008. The CD4+T-cell counts, CD8+T-cell counts were estimated by Flow cytometry.TLC, AEC, HB%, ESR were performed by standard hematological methods. Latex agglutination test was used to measure CRP. Results: The mean CD4+T-cell counts, CD8+T-cell counts and CD4+:CD8+ratio were found to be 308±296.8 (p<0.0001), 976.20±548.61 (p<0.0001) and 0.314±0.198 (p<0.0001) respectively. The hematological parameters estimated included were Hemoglobin (10.7±204), AEC (391.8±180.1), TLC (8595.8±2146.9) and ESR (75.625±29) Significant positive correlation was observed between CD4+T-cell counts and AEC,TLC, HB% and CD4+:CD8+ratio. ESR and CRP was found to be negatively correlating with CD4+T-cell counts. Conclusion: The study findings reemphasize the importance of alternate markers to assess the stage of the disease, initiate antiretroviral therapy and monitor the response in disease progression. The study results also suggested that there is necessity to evaluate the hematological parameters before initiating antiretroviral therapy.