BMC Hematology最新文献

Background: Malaria and human immunodeficiency virus are the two most devastating global health problems causing more than two million deaths each year. Hematological abnormalities such as anemia, thrombocytopenia and leucopenia are the common complications in malaria and HIV co-infected individuals. The aim of this study was to determine the effect of malaria infection on hematological profiles of people living with HIV attending Gambella Hospital ART clinic, Southwestern Ethiopia.

Objective: To determine the effect of malaria infection on hematological profiles of people living with HIV attending Gambella Hospital ART clinic, Southwestern Ethiopia.

Methods: A facility based comparative cross-sectional study was conducted from May 25 to November 11, 2014 in Gambella Hospital. A total of 172 adult people living with HIV (86 malaria infected and 86 malaria non-infected) participants were included in the study. Demographic, anthropometric and clinical data were collected. Venous blood samples and stool specimen were collected for laboratory analysis. Microscopic examination of peripheral blood films was done for detection of malaria parasites. Descriptive statistics, student T- test, bivariable and multivariable analyses were performed using SPSS V-20. Statistical significance was set at p < 0.05.

Results: A total of 172 adult people living with HIV were included in the study. The prevalence of anemia, thrombocytopenia and leucopenia in malaria and HIV co-infected participants were 60.5%, 59.3%, and 43.0%, respectively. Resident (AOR: 4.67; 95% CI: 1.44, 15.14), malaria infection (AOR: 2.42; 95% CI: 1.16, 5.04) and CD₄  ⁺ count were predictors for anemia. A predictor for thrombocytopenia was malaria infection (AOR: 9.79; 95% CI: 4.33, 22.17). Malaria parasitic density (AOR: 0.13; 95% CI: 0.03, 0.57) and CD₄  ⁺ count (AOR: 4.77; 95% CI: 1.23, 18.45) were predictors of leucopenia.

Conclusions: Findings suggest that the prevalence of anemia and thrombocytopenia were significantly higher in the malaria and HIV coinfected participants than the HIV mono-infected participants. Mean values of hematological profiles were significantly different in the two groups. Future prospective studies with larger sample size from other settings are needed to substantiate the findings.

Background: Anemia is a strong predictor of mortality and poor quality of life among persons with either renal impairment or HIV infection. In this study, we investigated the prevalence of anemia and its association with renal insufficiency among HIV infected patients initiating ART at a hospital in Northeast Ethiopia.

Methods: In this retrospective cohort study, records of 373 patients on ART were selected in Dessie Referral hospital, South Wollo, Northeast Ethiopia from September 2010 to August 2013. Socio-demographic and clinical characteristics of the study patients were collected using standardized data extraction instrument. The abbreviated 4-variable Modification of Diet in Renal Disease (MDRD) study equation was used to estimate renal function (GFR) from serum creatinine. SPSS version 20.0 statistical software was used for data analysis.

Results: The prevalence of anemia at the time of ART initiation was 34.4%; with 20.5, 12.3 and 1.6% mild, moderate and severe anemia, respectively. Renal insufficiency was present in 27.9% of patients and was associated with a high prevalence of anemia (74%). The prevalence of anemia increased with stage of insufficiency, from 23.7% in stage 1 to 100% in stage 4. Impaired renal function (eGFR < 60 mL/min/1.73 m²) was associated with a higher risk of all forms of anemia; i.e., mild (AOR = 3.96; 95% CI: 2.76-5.69), moderate (AOR = 2.21; 95% CI: 1.16-4.19) and severe anemia (AOR = 5.89; 95% CI: 1.02-12.03).

Conclusion: HIV infected patients with renal insufficiency had a higher prevalence of anemia compared to patients with normal renal function. Thus, screening of these patients for anemia and renal insufficiency at base line should be critical not only to reduce mortality but also to improve clinical outcomes.

Background: Chronic lymphocytic leukemia (CLL) is the most common leukemia in Western countries. The frequency of symptomatic central nervous system (CNS) involvement is unknown but thought to be a rare phenomenon. Currently there are no known risk factors for CNS involvement.

Case presentation: We describe a clinically staged low-risk CLL case that presented with symptomatic CNS involvement and progressed rapidly to death. Evaluation of the surface adhesion molecules identified a markedly altered expression pattern of the integrin, CD49d, and the tetraspanin, CD82, in the index case when compared to similar low-risk CLL cases. We found that the early Rai clinical stage CLL patients showed linear correlation for the co-expression of CD82 and CD49d. In contrast, this unique index case with CNS involvement, which has the same Rai clinical stage, had a significantly lower expression of CD82 and higher expression of CD49d.

Conclusions: These data suggest that the expression profile of CD49d and CD82 may represent potential biomarkers for patients with increased propensity of CNS involvement. Moreover, this study illustrates the critical need for a better mechanistic understanding of how specific adhesion proteins regulate the interactions between CLL cells and various tissue sites.