Bone marrow study in patients with Human Immune Deficiency Virus and Acquired Immune Deficiency Syndrome

Kenchappa RUDRESH ¹, Tirthankar MUKHERJEE ², Amit BHASIN ³, Vijaya Viswanath MYSOREKAR ⁴, Nalini MODEPALLI ⁵, Aparna AHUJA ⁶

¹ Department of Medicine, M.S. Ramaiah Medical College, Bangalore, ² Department of Medicine, Kempegowda Institute of Medical Sciences, Bangalore, ³ Department of Medicine, Lady Hardinge Medical College, New Delhi, ⁴ Department of Pathology, M.S. Ramaiah Medical College, Bangalore, ⁵ Department of Pathology, Kempegowda Institute of Medical Sciences, Bangalore and ⁶ Department of Radio-diagnosis, Maulana Azad Medical College, New Delhi, India.

ABSTRACT

Introduction: Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) can involve almost any organ system. The study was aimed to assess the various bone marrow abnormalities seen in HIV/AIDS patients with haematologic abnormalities. Materials and Methods: 43 HIV infected patients were included in the study. Baseline haematological investigations included full blood count, CD4 positive lymphocyte counts, and absolute lymphocyte count. Bone marrow aspiration and trephine biopsy were done in all patients. Bone marrows of these patients were carefully evaluated for any abnormalities. HIV positive patients were classified into AIDS group (76%) and non-AIDS (24%) group using National AIDS Control Organisation (NACO) criteria. Results: Normocytic normochromic anaemia was the most common peripheral haematological finding occurring in 72% of patients. The AIDS group had statistically significant lower platelet counts (p=0.004) but no differences in the other parameters. Bone marrow was normocellular in 63.6% in the AIDS group and 100% in the non-AIDS group. Dysplasia was observed in 37.2% of patients, predominantly affecting granulocytic series. Myelodysplasia was statistically associated with a low platelet count. Reduced marrow lymphoid precursors (CD4+) were seen in 37.2% of patients. Conclusions: Bone marrow abnormalities were common in HIV/AIDS patients with haematological abnormalities. The AIDS group had a statistically significant lower platelet count. Myelodysplasia was found in 37.2% of patients with HIV disease and was also statistically associated with a lower CD4+ lymphocyte count.

Keywords: AIDS related complex, bone marrow diseases, bone marrow examination, HIV infections

Correspondence author: Amit BHASIN, Lady Hardinge Medical College, New Delhi, INDIA. Tel: +91-9868658195. E mail: amitbhasin80@yahoo.com

Brunei Int Med J. 2011; 7 (3): 148-156