Published: 2019-05-24

Peripheral haematological manifestations in HIV infection and its relation to CD4 count

Lalit Jain, Amit A. Singh, Pratap S. Chauhan


Background: HIV infection is associated with a wide range of haematological abnormalities, which are amongst its most common complications. This study aims at discerning the peripheral haematological abnormalities associated with HIV infection and to correlate them with CD4 cell count.

Methods: An observational cross-sectional study was conducted from March 2017 till August 2018. 109 patients in 15 years or more age group who were HIV positive by the NACO guidelines were included. Complete hemogram, serum iron studies, serum folate and vitamin B12 levels, and flowcytometric CD4 cell count analysis were done for all the patients. Various haematological parameters were compared between the patients with CD4 cell counts <200/µl (n=52) to those with counts >200/µl (n=57). By using student t-test, the p-value was calculated for various parameters.

Results: Anaemia (58.7%), leucopenia (27.5%) and thrombocytopenia (17.4%) were seen with anaemia being the most common abnormality. Normocytic normochromic anaemia (65.6%) was the predominant type of anaemia. Overall analysis showed a statistically significant difference between two groups in haemoglobin concentration, RBC indices, serum ferritin values and absolute lymphocyte count; with p-value <0.05.

Conclusions: The diagnosis and treatment of haematological disorders are essential in medical care of the HIV-infected patients. Thus, in resource limited setups, where CD4 count analysis is not possible, haematological abnormalities can be used as tools for monitoring HIV positive individuals and can aid in the treatment of the patients.


Anaemia, CD4 count, HIV, Haematological abnormalities, Haemoglobin

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WHO Data and Statistics (July 2018). Summary of the global HIV epidemic. 2017. Available at: Accessed 24 March 2019.

UNAIDS report on the global AIDS report. UNAIDS 10th anniversary special edition, Geneva, 2006. Available at: Accessed 24 March 2019.

Costello CH. Haematological abnormalities in human immunodeficiency virus (HIV) disease. J Clin Pathol. 1988;41(7):711-5.

Henry DH, Hoxie JA. In:Hematology basic principles and practice. 4. Hoffmann R, Benz EJ, Shattil SJ, FurieB, Cohen HJ, Silberstein LE, and others, eds. Philadelphia: Churchill Livingstone; Hematological manifestations of AIDS; 2005:585-612.

Kratz A, Pesce MA, Basner RC, Einstein AJ. Laboratory values of clinical imprtance. In:Harrison's principles of internal medicine volume 2, 19th ed. 2015:2755-2756.

Bates I. Reference ranges and normal values. In Dacie & Lewis practical hematology, 12th ed. 2016:11.

Basu A, Ghosh K, Banerjee K. Bone marrow involvement in HIV infection: light, electron and immuno electron microscopic studies. Indian J Hematol Blood Transf. 1999;17(4):76-86.

Kumawat S, Kochar A, Sirohi P, Garhwal J. Socio-demographic and clinical profile of HIV/AIDS patients in HAART era at a tertiary care hospital in North-West Rajasthan, India. Int J Comm Med Public Health. 2017;3(8):2088-93.

Mocroft A, Kirk O, Barton SE, Dietrich M, Proenca R, Colebunders R, et al. Anaemia is an independent predictive marker for clinical prognosis in HIV-infected patients from across Europe. AIDS. 1999;13(8):943-50.

Sitalakshmi S, Srikrishna A, Damodar P. Hematologic changes in HIV infection. Indian J Pathol Microbiol. 2003;46(2):180-3.

Tripathi AK, Kalra P, Misra R, Kumar A, Gupta N. Study of bone marrow abnormalities in patients with HIV disease. JAPI. 2005;53:105.

Kathuria S, Bagga PK, Malhotra S. Hematological Manifestations in HIV Infected Patients and Correlation with CD4 Counts and Anti Retroviral Therapy. J Contemp Med Res. 2016;3(12):3495-8.

Erhabor O, Ejele OA, Nwauche CA, Buseri FI. Some haematological parameters in human immunodeficiency virus (HIV) infected Africans: the Nigerian perspective. Nigerian J Med. 2005;14(1):33-8.

16. Kumar MB, Thippeswamy T, R Shankar R, Prathima C. Hematological abnormalities in early and advanced HIV infection patients. Int J Scientific Study. 2016;3(11):1-5.

Semba RD, Shah N, Klein RS, Mayer KH, Schuman P, Vlahov D. Human Immunodeficiency Virus Epidemiology Research Study Group. Prevalence and cumulative incidence of and risk factors for anemia in a multicenter cohort study of human immunodeficiency virus–infected and–uninfected women. Clin Infect Dis. 2002;34(2):260-6.

Dikshit B, Wanchu A, Sachdeva RK, Sharma A, Das R. Profile of hematological abnormalities of Indian HIV infected individuals. BMC Hematol. 2009;9(1):5.