Thrombocytopenia in haart naive HIV infected Patients attending the comprehensive care Clinic at Kenyatta national hospital

Abstract

Background: Haematological abnormalities are common in HIV infected patients. Thrombocytopenia has been associated with progression of disease. The presence of thrombocytopenia is significantly associated with decreased survival and is a predictor of mortality. Objective: To study the prevalence of thrombocytopenia and clinical characteristics in HIV infected patients who are HAART naive attending the Kenyatta National Hospital Comprehensive Care Centre. Study Design A cross sectional Descriptive Study. Study site: Kenyatta National Hospital Comprehensive Care Centre Methods: HIV positive HAART narve patients who fulfilled the study inclusion criteria were recruited. History and physical examination was done. Blood was drawn for total blood count, Peripheral blood film and CD4 count. RESULTS 340 HIV infected HAART naive patients with a mean age of 37.3years and range of 18years to 72years were recruited. The male to female ratio was 1:1.6.The study population mostly comprised of; young patients (39.9% between 30-40yrs), females (61.6%) in WHO clinical stage I (57.6%) and with CD4 count between 200-500 cell/mm3 . The mean platelet count was 230,000 cells/ul. The prevalence of thrombocytopenia in this population was 3.8%. Most of the patients with thrombocytopenia had a bicytopenia with the rest having isolated thrombocytopenia or pancytopenia. Bleeding tendencies were more in the thrombocytopenia group (p= 0.011). Patients in WHO Clinical Stage IV were more likely to have thrombocytopenia (p <0.011) as well as those with CD4 count < 200cells/mm3 (p <0.050). Conclusion The prevalence of thrombocytopenia is low among HIV infected HAAR T naive patients attending the Kenyatta National Hospital Comprehensive Care Clinic. This could be attributed to young age, predominant female gender and early disease in the study population.