Thrombocytopenia according to Antiretroviral Drug Combinations, Viremia and CD4 Lymphocytes among HIV-Infected Patients in Cameroon A Snapshot from the City of Yaoundé [post]

2019 unpublished
Objective: Thrombocytopenia is an abnormal decrease in blood platelets, which can affect the prognosis of people living with HIV (PLHIV). In order to assess the burden of this haematological disorder, we evaluated the frequency of thrombocytopenia according to antiretroviral drug combinations, viremia and the immune status of PLHIV. Results: A cross-sectional and analytical study was conducted from June-November 2016 among 310 PLHIV at the "Chantal BIYA" International Reference Centre, Yaoundé,
more » ... ce Centre, Yaoundé, Cameroon. Overall rate of thrombocytopenia was 19.0% (59/310).The rate of thrombocytopenia was 64.6% (42/65) versus 6.9% (17/245) in ART-naïve versus ART-treated patients respectively, p<0.0001. Following viral load, rate of thrombocytopenia was 15.8% (20/130) in those with undetectable viral load, and 34.1% (27/79) with viral loads>3 log10 RNA/ml (p=0.03). As concerns CD4-count, rate of thrombocytopenia was 16.2% (42/259) in those with ≥200 CD4/mm 3 versus 33.3% (17/51) with <200 CD4/mm 3 (p=0.0003) . After adjusting for sex, ART, viral load and CD4, Viral load and ART exposure were significantly associated with decreased risk of thrombocytopenia (p<0.05). Thrombocytopenia occurs especially among ART-naïve, high viremia and severe immune-compromised patients. Interestingly, ART coverage appears as an independent factor in preventing the occurrence of thrombocytopenia. 77.09 and ranged from 34.000 to 466.000 / μL. CD4 lymphocyte count and blood platelet count According to CD4 T lymphocytes, mild thrombocytopenia was 33.33% (17/51) among those with severe immunodeficiency, with a statistically significant difference (p=0.003) as compared to those with higher CD4. Furthermore, a weak positive and significant correlation was found between CD4 count and platelet count, r=0.21 (Table 2) . HIV viral load and platelet count Up to 34.1% (27/79) of thrombocytopenic patients were on viral load >3log10, a significant higher burden as compared to those with low-level viremia, p=0.037 (Table 2) . Furthermore, a weak negative correlation was found between platelet count and viral load; r=-0.12. ART-exposure and blood platelet count Among naïve PLHIV, 64.6% (42/65) of cases of thrombocytopenia were observed compared to 6.9% (17/245) in treated patients. Depending on the type of ART, 28.9% (11/38) of Thrombopenia patients were observed among patients on AZT-containing HAART compared to 2.9% (6/207) non-AZT containing HAART, p<0.001. Adjusting for sex, ART exposure, viral load and CD4 to blood platelets counts After adjusting for sex, ART, viral load and CD4, Viral load and ART exposure were significantly associated with decreased risk of thrombocytopenia (p<0.001). Discussion
doi:10.21203/rs.2.13357/v2 fatcat:jeqqcz656vd4nd6dzmbxvbkmci