Determination of haematological and biochemical abnormalities in HIV/AIDS infected patients receiving highly active antiretroviral therapy at the Effiankwanta Regional Hospital in the Western Region.

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The introduction of HAART has led to a significant improvement in prolonging survival of HIV-infected patients on treatment in resource-limited areas. Nevertheless, the key problem of HAART that long-term use has the potential to cause haematological and biochemical abnormalities that may be life-threatening. These significant difficulties sometimes permit change or discontinuation of ART. Data on the prevalence of the above complications in Ghana is limited. The current study assessed the haematological and biochemical abnormalities in HIV/AIDS infected persons that may be associated with the administration of HAART and their virological responses of which 200 seropositive HIV patients were tested pre and post HAART based on clinical laboratory biomarkers in a comparative cross-sectional study. Results were matched for gender, age and HAART status. The data was analyse using SPSS, Paired sample t-test and One-way ANOVA.The prevalence of haematological cytopenias (Anaemia, leucopenia, neutropenia, lymphopenia and thrombopenia) which were classified into mild, moderate and severe saw significant reduction after treatment. The degree of cytopenias among gender was higher in females as compared to male post treatment. There was significant change in the levels of ALT and ALP which may indicate an association with hepatocellular injury with HAART treatment in participants with HIV infection. When creatinine clearance/glomerular filtration rate (GFR) was measured to determine degree of renal dysfunction and the prevalence of chronic kidney disease among HIV seropositive before and after medication. There was a reduction in renal dysfunction and chronic kidney disease when CKD-EPI equation was used post-HAART (18%-16.5%).This shows that renal pathology appeared to have improved after HAART, being an indication of ART ability to resolved renal disorders. The average viral load significantly reduced from 137966.30±4.05 in mean (copies/ml) to 2037.49±22.86 (copies/ml) after treatment (p-<0.0001). Viral load decrease significantly after HAART among males and females, [176441.20±3.65 vs 2641.19±24.17 and 128558.26±4.16 vs 1891.47±22.73] (copies/ml) respectively (p-<0.0001, p-0.0001). HAART had a weak effect on viraemia (n2-0.028), moderate effect on haemoglobin (η2 - 0.048), weak effect on total protein (n2-0.041) and moderate effect on serum albumin (η2 - 0.07). HAART therefore had a positive impact on viraemia, haematological and biochemical parameters as compare to HIV infection. Immunological status must be determined through CD4 count test.
A thesis submitted to the Department of Clinical Microbiology, College of Health Sciences, Kwame Nkrumah University of Science and Technology in partial fulfilment of the requirements for the award of degree of Master of Science in Clinical Microbiology, 2016.