UNVEILING THE POTENTIAL OF HEMATOLOGICAL ABERRATIONS IN HIV INFECTION AS A RELIABLE SURROGATE FOR CLINICAL STAGING

Abstract

Background: The global incidence of HIV has declined since peaking in the mid-nineties, mainly due to advancements in diagnostics, therapeutics, and global health initiatives. Despite these advancements, resource-limited countries still face challenges accessing timely diagnostic tests and treatments. Hematological assays are one of the most widely available and least expensive laboratory tests worldwide, often with a short test-to-report time. To evaluate common hematological abnormalities in newly diagnosed HIV patients and correlate these with the WHO clinical stages of HIV infection we conducted this study.

Methods: A cross-sectional study was conducted at a tertiary care center in Kerala, India. Newly diagnosed HIV patients aged 15 years and above were enrolled, excluding those with chronic diseases or conditions affecting hematological profiles. Comprehensive evaluations, including hematological tests and WHO clinical staging, were performed. Statistical analyses assessed correlations between hematological parameters and clinical stages.

Results: Among 120 patients (59.17% males, mostly aged 25-50), unprotected sexual contact was the primary transmission route. Mucocutaneous candidiasis and tuberculosis were the most common opportunistic infections. Hematological abnormalities included elevated erythrocyte sedimentation rate (81.7%), anemia (80%), reticulocytopenia (26.7%), and thrombocytopenia (14.2%). Hemoglobin, total

Leukocyte, lymphocyte, and CD4 counts significantly correlated with clinical stages. Hemoglobin levels showed a strong negative correlation with disease stage  (r -0.827), with predictive values indicating stage severity. Similarly, lymphocyte counts and ESR showed significant correlations with advancing disease stages.

Conclusion: Hematological parameters, particularly hemoglobin, lymphocyte counts, and ESR, significantly correlate with the WHO clinical stages of HIV infection. These findings support the utility of these parameters as surrogate markers for assessing disease severity, especially in resource-limited settings. Further research is needed to enhance diagnostic and treatment approaches in these regions.