Hematological profiles and associated factors among adult hiv positive individuals before and on highly active antiretroviral treatment: a cross sectional study in madda walabu university goba referral hospital, southeast Ethiopia

Abstract

Background: Hematological abnormalities are common in human immunodeficiency virus (HIV) positive individuals and increase the risk of morbidity and mortality. It is stated in different literatures that the prevalence of hematological abnormalities due to HIV before highly active antiretroviral therapy (HAART) initiation is more prevalent than after HAART initiation. However, there is limited data on the profiles of hematological abnormalities in HIV positive adult individuals in Southeast Ethiopia. Objective: This study was aimed to determine the hematological profiles and associated factors among adult HIV positive individuals before and on highly active antiretroviral treatment at Madda Walabu University Goba Referral Hospital, Southeast Ethiopia. Methods: A facility based cross-sectional study was conducted involving adult HIV positive individuals from April 1 to June 30, 2018 at Madda Walabu University Goba Referral Hospital. A total of 308 HIV positive adult individuals were included in this study. Data on socio-demographic characteristics and clinical data of the study subjects were collected using structured questionnaire. Hematological and immunological parameters were measured. Stool examination for intestinal parasites and blood film for hemoparasites were done. Data were entered into EpiData 3.1 and analyzed using SPSS V-20.0 statistical software. P- Values<0.05 were considered as statistically significant. Results: The prevalence of anemia, leukopenia and thrombocytopenia was 31.8%, 18.2% and 11.4% before HAART while 14.6%, 24% and 4.5% in HIV positive individuals on HAART, respectively. There were significant differences between on mean values of RBC, Hgb, Hct, MCV, MCH, RDW, TLC, PLT and CD4+counts between pre-HAART and on HAART. CD4 count<200cells/µl (AOR=4.2, 95% CI :( 1.4-4.8) was the only independent risk factor of anemia and leukopenia in HIV positive individuals before HAART. WHO clinical stage IV (AOR=2.4, 95% CI :( 1.4-4.8), female (AOR=2.6, 95% CI: 1.3-4.8), HAART regimen (ZDV, 3TC, NVP (AOR=3.2, 95% CI :( 2.2-7.5) and having intestinal parasites infection (AOR=2.5, 95% CI :( 1.1-7.4) were found to be significant predictors of anemia on HAART HIV positive individuals. Conclusion: There was a decline in the prevalence of anemia and thrombocytopenia among HIV positive individuals after ART initiation. There was differences prevalence of hematological abnormalities between HIV positive individuals before and on HAART. Hematological abnormalities in HIV positive individuals before and on HAART had different risk factors. Therefore, regular follow-up are necessary to prevent hematological abnormalities.