Effect of Antiretroviral Regimens on Haematological and Immunological Abnormalities of People Living With Hiv in a Comprehensive Care Centre in Kiambu County, Kenya

Abstract

Abstract

Background: Haematological abnormalities are linked to a higher risk of HIV disease progression and mortality. Quality of life is enhanced via the restoration and maintenance of immune function through the efficient administration of antiretroviral treatment (ART). Nevertheless, ART has the potential to favorably or adversely affect haematological parameters. The purpose of this study was to compare the effects of various ART regimens on immunohaematological parameters abnormalities in adult patients living with HIV.

Methods: This cross-sectional study enrolled 237 participants, between July 2022 to December 2023 at Thika Level Five Hospital's Comprehensive Care Centre (CCC) in Kiambu County, Kenya. Total blood count and the CD4+ T cells count were measured using standard laboratory procedures. Sociodemographic data, clinical characteristics and type of ART regimens were collected by use of a structured questionnaire and review of patient medical records.

Results: The mean levels of PLT, ALC, HB, MCV, MCH, PCV, of ART – treated was significantly higher compared with those of ART – naïve (p <0.05). However, the mean levels of CD4 count showed no statistically significant difference between ART-treated and ART-naïve individuals (p=0.5045). TDF/3TC/DTG regimen was associated with higher lymphopenia rates ((50.00 %, p = 0.0252) while AZT/3TC/ATV/r was associated with high rates of macrocytosis (35.29%, p<0.0001).  Hypochromia was significantly higher in those on TDF/3TC/DTG (94.12%, p=0.0268). Elevated RDW was more frequent in patients on TDF/3TC/DTG (60.00%, p=0.0044).

Conclusion: PLT, ALC, HB, MCV, MCH, PCV, of ART – treated were significantly higher compared with those of ART – naïve. TDF/3TC/DTG regimen significantly influenced lymphopenia while AZT/3TC/ATV/r was associated with high rates of macrocytosis. Regular monitoring and treatment of HIV- infected patients on ART for haematological and immunological abnormalities is vital in order to reduce HIV- related morbidities. Clinicians should consider ART –associated adverse effects when selecting ART regimens.