ASSESMENT OF BASIC HEMOSTATIC PROFILES AMONG HUMAN IMMUNODEFICIENCY VIRUS INFECTED ADULTS IN CORRELATION TO CD4 COUNT AND ANTIRETROVIRAL THERAPY, AT UNIVERSITY OF GONDAR HOSPITAL, GONDAR, NORTHWEST ETHIOPIA.

Abstract

ABSTRACT Back ground: - Human immune deficiency virus infection (HIV) causes haematological abnormalities including impaired haematopoiesis, immune-mediated cytopenias and altered hemostasis mechanisms. Hemostasis system abnormality in HIV infected individuals caused by endothelial dysfunction, presence of anti phospholipids antibody, liver disease and bone marrow dysfunction. Objective: To assess basic hemostatic profiles of HIV infected adults in correlation to CD4 count and highly active antiretroviral therapy (HAART), at University of Gondar hospital antiretroviral therapy clinic. Methods:- A comparative - cross sectional study was conducted from February to May 2017, among 300 study participant, consists of 100 HAART-naive, 100 on-HAART HIV-infected adults and 100 HIV-seronegative adults at University of Gondar hospital. Venous blood was collected to perform coagulation tests (Prothrombin time (PT), activated partial thromboplastin time (aPTT) and international normalization ratio (INR)), cluster of differentiation 4 (CD4) count, platelet count and serological tests. The data were entered, cleaned and edited using EPI info version 7 and analyzed using SPSS version 20. Data were analyzed by using Kruskal Wallis H, Mann-Whitney U test and Spearman correlation tests. Test result were expressed by median [interquartile] and presented by using texts and tables. P-Value < 0.05 was considered as statistically significant. Results: - PT, aPTT and INR were significantly higher and platelet count significantly lower in HIV infected adults (both on-HAART and HAART-naive) than HIVseronegative adults (P <0.001). PT and INR were significantly higher and platelet counts significantly lower in HAART-naive HIV infected adults than on-HAART HIV infected adults (P<0.05). In spearman correlation test APTT of HAART-naive individuals was inversely correlates with CD4 count. However, HAART duration did not show significant difference in all parameters (P >0.05). Conclusion and recommendation: - HIV infected adults are more likely to develop coagulation abnormality than HIV-seronegative subjects. Coagulation test and platelet count should be used to monitor coagulation disorder in HIV infected individuals. Key words:-coagulation, PT, aPTT, INR