The Effect Of HAART On The Blood Routine Examination Of AIDS Patients

AIDS is a infectious disease by human immunodeficiency virus (HIV). The World Health Organization(WHO) reported the number of people living with HIV was 33.4 milin, and the number of newly infected with HIV was 2.7 million in 2008. The estimated number of HIV infected individuals in China now is 700,000, but the real number may be far more than that. AIDS is a serious threat to human.HAART is the only effective treatment for AIDS at present, which can suppress HIV virus replication effectively, restore the immune system and improve prognosis significantly. The viral load and CD4+T cell counts are the golden standards to evaluate HAART, but aren't measured routinely in AIDS patients in resource-limited settings. Many studies have found that hemoglobin and total lymphocyte (TLC) were correlated with the progression of AIDS, so WHO recommended that when CD4 cell count is not available or is not affordable to obtain for HIV-infected individuals, TLC of 1200/mm3 or below in individuals may be used as an indication to initiate ART in resource-limited settings[1l One cohort study found that the decrease of Hb is related with the decline of CD4+T cell[2], and the increase of Hb and TLC indicate the success of treatment [5lThere are rare reports about the progression on blood routine examination and HIV infection in China. In order to further analysis the relationship between Hb, TLC and the effect of HAART, we selected some Chinese HIV/AIDS patients and compared with healthy control, to reveal the effect of the effective HAART on the blood routine, and the relationship between the blood routine and disease progression. The existing studies are based on short-term observation, so we studied the change in Hb and TLC of German who had received HAART for nine years, to find the relationship between the blood routine and VL and CD4+T cell counts, and to provide a supplementary reference for the clinical in HAART.1. Background and aimsThe relationship between blood routine and CD4+T cell counts of AIDS is not well documented. This study aimed to identify the change of TLC and Hb though short-term and long-term HAART, and the correlation between CD4 and TLC and Hb.2. MethodsAll cases In this study belong to AIDS or HIV infection stage in accordance with the WHO HIV infection staging system. The enrolled subjects include 27 HIV infections,38 AIDS patients receiving 1-2 years HAART,40 healthy control, and 47 German AIDS who received nine years HAART. CD4+T lymphocyte counts were measured by flow cytometer and plasma HIV RNA levels were measured by quantitative reverse transcriptase-polymerase chain reaction.3. Results3.1 the situation before HAART3.3.3 The mean level of CD4+T cell counts in healthy control is 812.74±12.91 cells/ul, and 443.88±33.85 cells/ul in HIV infections, and 62.74±13.06 cells/ul in AIDS patients. The mean level of CD4+T cell counts in AIDS patients and HIV infections is significantly lower than healthy control, P＜0.01; The mean level of CD4+T cell counts in AIDS patients is obviously lower than HIV infections too, P＜0.01.3.2.2 The mean level of TLC counts in healthy control is 2302.38±72.25 cells/ul, and 2154.96±97.36 cells/ul in HIV infections, and 1283.48±227.28 cells/ul in AIDS patients. The mean level of TLC in AIDS patients is significantly lower than healthy control, P＜0.01.3.3.3 The mean level of Hb concentration in healthy control is 141.79±1.59 cells/ul, and 2107.32±2.63 cells/ul in HIV infections, and 96.52±4.11 cells/ul in AIDS patients. The mean level of Hb concentration in HIV infections and AIDS patients are significantly lower than healthy control, P<0.01; The mean level of Hb concentration in HIV infections is obviously lower than healthy control too, P<0.01.3.1.4 The mean level of platelet counts in healthy control is (205.40±69.35) x 109 cells/ul, and (179.80±18.23)×109 cells/ul in HIV infections, and (179.80±18.23) x 109 cells/ul in AIDS patients. The mean level of platelet counts in HIV infections and AIDS patients are lower than healthy control, but there is no statistical significance in different groups, P=0.11, P=0.166; The mean level of platelet counts in AIDS patients is lower than HIV infections, but there is no statistical significance either,P=0.899.3.2 the situation after HAART3.2.1 The mean level of CD4+T cell counts, TLC and Hb concentration increased continuously after the effective short-term HAART, and kept fluctuating in nomal range. The mean level of TLC and Hb is positively correlated with CD4+T cell counts.3.2.2 the situation after long-term HAART3.2.2.1 The mean level of virus loads (VL) of good response groups decreased continuously with the prolongation of HAART, and mean level of CD4+T cell counts, Hb and TLC increased persistently. The mean level of CD4+T cell counts is positively correlated with Hb concentration and TLC.3.2.2.2 The mean level of VL of poor response groups decreased in the first five years, but increased again in the 6th year and maintained the high level. The mean level of CD4+T cell counts and Hb concentration increased in the first five years, but declined in the 6th year. The mean level of CD4+T cell counts and Hb concentration increased in the first five years, but declined in the 6th year. The mean level of TLC increased in the first six years, but duclinde in the 7th yuar. CD4+T cell counts are positively correlated with Hb concentration and TLC.3.2.2.3 The mean level of CD4+T cell counts, TLC and Hb concentration in poor virological response groups and good virological response groups have no statistically significant differences, but mean level of CD8+T cell counts has statistically significant differences from 5 year to 9 year of HAART. 4. Conclusion①For the AIDS patients who received HAART, no matter long-term or short-term HAART, TLC and Hb concentration are closely positively correlated with CD4+T cell counts, and can be used as one of substitute markers to assess the effect of HAART in resource-limited settings.②CD4+T cells commonly reflect the immune response in HIV/AIDS patients. In most patients from this study, the number of CD4+T cells was constantly raising along with the duration of the therapy, whatever in sustained virological response group or in virological failure group. Therefore, it is reasonable to conclude that total lymphocyte count, the level of Hb concentration were in good correlation with the immunological marker, such as CD4+T count.