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 determine the prevalence of thrombocytopenia and clinical characteristics of HIV infected patients who are HAART naive attending the Kenyatta National Hospital Comprehensive Care Clinic.. Design: Cross-sectional descriptive Study. Setting: Kenyatta National Hospital Comprehensive Care Clinic. Subjects: HIV positive HAART naive patients. Results: Three hundred and forty 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 comprised mostly 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 (66.7%) with thrombocytopenia had a bicytopenia with the rest having isolated thrombocytopenia or pancytopenia. Bleeding tendencies were observed more in the thrombocytopenia group (p= 0.011). Patients with CD4 count < 200cells/mm3 were more likely to have thrombocytopenia (p <0.050). Conclusion: The prevalence of thrombocytopenia is low among ambulant HIV infected HAART naive patients attending the Kenyatta National Hospital Comprehensive Care Clinic. This could be attributed to young age, predominant female gender and early disease WHO Stage 1 in the study population. Other studies found older age, male gender and advanced HIV infection population to be determinants where higher prevalence of thrombocytopenia have been reported.