Background: Acquired Immunodeficiency Syndrome (AIDS) is caused by the HIV virus and characterized by severe immunosuppression that leads to opportunistic infections, haematological aberrations, neoplasms and various deleterious effects on almost all the organs. It is still a major health challenge in the modern world and persistently imposing threats to the health-care initiatives the resource-poor South-east Asian countries.
Aim: To present an overview regarding the haematological aberrations in HIV infected and AIDS patients.
Discussion: AIDS involves almost all the systems in human body. Hematologic abnormalities are among the most common complications of HIV. These involve all the lineages of the blood cells. Anaemia is the most common hematologic abnormality affecting 60% to 80% of patients in the late stage disease with high viral load. Neutropenia is caused by inadequate production and thrombocytopenia by immune-mediated destruction of platelets in addition to inadequate production. As the infection progresses, there is development of pancytopenia. HIV infection may also lead to haemolytic anaemia especially microangiopathic haemolytic anaemia, coagulation cascade deregulations, lymphoproliferative disorder and opportunistic infection due to multifarious aetiologies. HIV associated hematologic expressions seem to be dependent on the level of viral replication, as these abnormalities are severe in AIDS patients with high viraemia and decreased CD4 counts. Bangladesh is still considered to be a low prevalence country for HIV, but it remains extremely vulnerable because of its dire poverty, overpopulation, illiteracy, gender inequality, high mobility of the population in country, recent influx of 1.1 million Forcibly Displaced Myanmar Nationals (FDMN) and high level of transactional sex. Migration to other countries for employment is also very frequent, particularly amongst younger people. HIV and AIDS is not merely a health issue, rather has tremendous economic and social impacts for the most productive age group of the society that is infected. Although the estimated total number of HIV infections is around 14,000 (Ref: UNAID 2019 HIV estimate), the key population groups (sex workers, homosexuals and intravenous drug abusers) include around 300,000. Other risk groups include adolescents, migrant workers, clients of sex workers, non-injecting drug users, and partners of key populations, who are millions in numbers. A significant part of all key and vulnerable populations is adolescents and young people who often have limited knowledge about HIV/AIDS because of social barriers.
Conclusion: Knowledge on different abnormalities due to HIV infection will help the physicians as well as the patients to take precautionary measures and early effective therapies at any stage of the disease.
Keywords: Human Immunodeficiency Virus (HIV), Acquired Immunodeficiency Syndrome (AIDS), HIV/AIDS in Bangladesh.
Correspondence: Maj (Dr) Md Moshiur Rahman, Haematologist, AFIP, Dhaka. Email: [email protected]