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Hematological alterations associated with antiretroviral therapy in patients with human immunodeficiency virus

Abstract:

Introduction: hematological alterations are very frequent and of multifactorial origin, they have been related to an increased risk of pathology progression and morbimortality in patients infected by the human immunodeficiency virus. Although there is a wide variety of scientific studies on the prevalence and pathogenesis of these alterations in HIV-positive patients, there are few investigations in our environment that report on the positive or negative effect of the administration of antiretroviral drugs. Objective: to determine the main hematologic alterations associated with antiretroviral therapy in patients infected by the human immunodeficiency virus. Method: narrative bibliographic review. The following databases were used for the research: PubMed, Cochrane and Scopus. Results: the prevalence of at least one hematological alteration was 1,1-58,6 % among HIV-infected patients receiving ART. The most frequent cytopenia was anemia followed by leukopenia and thrombocytopenia. Among the most significant risk factors, patients older than 50 years, female sex, zidovudine-based antiretroviral regimen, low BMI and CD4 T-cell count, high viral load, advanced stage and opportunistic infections were identified. Conclusions: the toxicity of antiretroviral drugs and the clinical conditions of the HIV-positive patient result in altered hematopoiesis affecting all three cell lines, patients may present with anemia, leukopenia, thrombocytopenia and/or pancytopenia. Failure to monitor and identify these disorders has a serious impact on the natural history of the disease in the patient.