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Year : 2011  |  Volume : 2  |  Issue : 1  |  Page : 15-21

Antiretroviral therapy and haemostatic parameters in HIV patients with haemoglobin phenotypes AS and AA

1 Department of Haematology, Federal Neuropsychiatric Hospital, Yaba, Lagos, Nigeria
2 Department of Haematology, School of Medicine, College of Medical Sciences University of Benin, Benin City, Nigeria
3 Department of Medical Laboratory Sciences, School of Basic Sciences, College of Medical Sciences, University of Benin, Benin City, Nigeria

Correspondence Address:
O A Awodu
Department of Haematology, School of Medicine, College of Medical Sciences, University of Benin, Benin City
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Source of Support: None, Conflict of Interest: None

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Background: Haematological and coagulation defects have been reported in advanced HIV infection, the occurrence of the S gene is high in African Blacks. HIV infection is on the increase in Nigeria. About a quarter of Nigerians have haemoglobin phenotype HbAS. The haemostatic parameters have not been fully determined in Nigerians with haemoglobin HbAS Aims: To determine the effects of HIV infection on haematological and haemostatic profiles of Nigerians with the sickle cell trait : haemoglobin As(HbAS) and haemoglobin AA(HbAA) Methods: Subjects comprised of phenotype HBAS and HB AA patients who were newly diagnosed with HIV infection and those already on antiretroviral therapy(ART). Control group comprised of apparently healthy subjects with haemoglobin phenotypes AS and AA. Blood samples were analysed for haematological parameters :(haematocrit(Hct), total white cell count (WCC), platelet count(Plt)) and Haemostatic parameters: (plasma fibrinogen concentration(Pfc), prothrombin time(PT) and Activated partial thromboplastin time(APTT) . All analyses were carried out using standard techniques. Quantitative assay was conducted to estimate D-dimer levels. Results: A total of 145 subjects were studied. The mean haemoglobin(Hb), and WCC were higher in HBAS than HbAA subjects with HIV infection but the differences in the mean values were not Statistically significant(p>0.5). The PT, APTT and the Pfc were significantly more prolonged in HBAS with HIV infection than in Hb AS controls (p<0.0001). The haemostatic parameters were also significantly more prolonged in HBAA with HIV than HbAA HIV negative controls (p<0.0001). Elevation of D-dimer was found in 12 and 20% of HbAS and HbAA HIV positive subjects respectively. Positive D-dimer was found to be significantly associated with HIVinfection (p = 0.0007) in both HbAS and HbAA subjects. Conclusion: This study has shown that Hb phenotype does not influence the effect of HIV infection on haemostatic and haematological parameters. Elevated plasma fibrinogen concentration, prolongation of APTT and presence of D-dimer, in HIV infection may suggest an inflammatory response as well as subclinical coagulapathy

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