Changes in hematological profile of HIV infected pregnant women after receiving highly active antiretroviral therapy at Debreberhan referral hospital and Debreberhan health center, Debreberhan, Ethiopia

Abstract

Background: Hematological complications have been documented to be the second most common cause of morbidity and mortality in HIV positive persons. In addition, treatment of HIV/AIDS showed side effects on hematological parameters. This study assessed hematological profile of HIV infected pregnant women after initiation of highly active antiretroviral treatment including the new Tenofovir drug.

Method: Retrospective cohort study was conducted to assess hematological profile of HIV infected pregnant women after initiation of HAART at Anti-Retroviral Therapy (ART) clinic of Debreberhan referral hospital and Debreberhan health center in Ethiopia from January to August 2016.  Data was collected from 51 patient cards of pregnant women that are available at the two health facilities between September 2009 and August 2016.The data was entered into Excel spread sheet and it was transported into STATA software for analysis. All data were presented as mean ± Standard error of the mean. Comparisons were made using the Paired T-test. A p-value of <0.05 was considered as indicative of a statistically significant difference.

Result: The result from the present study shows that the HAART initiation in pregnant women with HIV increases the CD4 cell count and decreases means corpuscular hemoglobin concentration whereas other hematological parameters assessed here (WBC, lymphocyte count, total mid cell count… PCT) are not significantly affected at ninety five percent confidence interval. From the total of fifty one patient cards with complete CD4 count, twenty nine patient cards were recorded with TDF/3TC/EFV ART regimen. The remaining twenty two patient cards were documented with AZT/3TC/NVP regimen. Comparing the effect of the two Regimens on CD4 count, TDF/3TC/EFV increases the CD4 count significantly in pregnant women with HIV (p<0.0001). The other regimen (AZT/3TC/NVP) also increases the CD4 count from initial value as it is indicated by positive paired mean difference but this increase in CD4 count after AZT/3TC/NVP initiation in pregnant women with HIV is not statistically significant at 95 percent confidence interval.

Conclusion: HAART initiation in pregnant women with HIV increases the CD4 cell count and decreases means corpuscular hemoglobin concentration. TDF/3TC/EFV ART regimen increases the CD4 count in pregnant women with HIV.