Haematological and Immunological Abnormalities in People Living With HIV: A Review

Abstract

Haematological and immunological abnormalities abound in HIV infections. Reduced CD4+ T cells, changes in cytokine profiles, and impaired immunity are the key immunological changes seen in HIV infection. The immune system becomes dysregulated when HIV targets multipotent haematopoietic progenitor cells, which disrupts the bone marrow microenvironment. This affects proper haematopoiesis due to cytokine imbalances and disruption of other elements necessary for haematopoiesis. Hence, haematological abnormalities, especially cytopenias often manifest in HIV- infected individuals. A number of reasons contribute to the complicated pathophysiology of these disorders, including HIV's direct effects on haematopoiesis, suppression of the bone marrow due to cancer or infection, adverse effects of antiretroviral (ARV) medications, immune-related issues, and opportunistic infections. This research compiles and analyses regional data on the frequency of cytopenias in HIV-infected individuals, including anaemia, leukopenia, and thrombocytopenia and their causes. Additionally, it evaluates the effects of antiretroviral medication on cytopenias and CD4 counts, and investigates the connection between these cytopenias and immunological indicators like CD4 count. Also included are suggestions for future studies and areas where studies are lacking.