HIV-Associated Hematologic Disorders Are Correlated With Plasma Viral Load and Improve Under Highly Active Antiretroviral Therapy.

Clinical Science

JAIDS Journal of Acquired Immune Deficiency Syndromes. 28(3):221-225, November 1, 2001.
Servais, Jean *; Nkoghe, Dieudonne +; Schmit, Jean-Claude *++; Arendt, Vic *++; Robert, Isabelle *; Staub, Therese ++; Moutschen, Michel +; Schneider, Francois *[S]; Hemmer, Robert *++

Abstract:
Summary: The relationship between HIV-1 replication and hematologic parameters was examined in two separate studies. The first study was a cross-sectional evaluation of 207 untreated patients. In this study, the proportion of patients with hematologic disorders increased with disease progression. There was a significant inverse correlation between HIV-1 plasma viral load and all hematologic values (r = -0.266 to -0.331). The second study was a longitudinal evaluation of patients on combination antiretroviral therapy (HAART) with hematologic alterations before treatment (N = 27 with platelets <150,000/[mu]l, 24 with hemoglobin <12 g/dl, 36 with neutrophils <2000/[mu]l and 29 with leukocytes <3000/[mu]l). Samples were analyzed every 3 months for 2 years. At 2 years, >50% of patients experienced a sustained virologic response, with viral loads <500 RNA copies/ml. Hematologic reconstitution occurred progressively for all blood cell lineages and became statistically significant after the sixth month of therapy (p < .001). Mean values increased from 110 to 180 x 10 3 /[mu]l for platelets, from 10.7 to 12.3 g/dl for hemoglobin (stabilizing finally at 11.4 g/dl), from 1,260 to 2,240/[mu]l for neutrophils, and from 2,260 to 3,600/[mu]l for leukocytes. In conclusion, hematologic disorders are corrected by combination antiretroviral therapy. This suggests a causative role of HIV-1 in hematologic disorders.

(C) 2001 Lippincott Williams & Wilkins, Inc.