Haematological Abnormalities in Treatment Naive Multidrug-Resistant Tuberculosis Patients with or Without Human Immunodeficiency Virus (HIV) Infection

Abstract

Presently, there is the dearth of information on the impact of human immunodeficiency virus (HIV) infection on haematological parameters in patients with multidrug resistant tuberculosis (MDR-TB). Therefore, this study was carried out to determine the levels of selected haematological parameters in MDR-TB patients with or without HIV co-infection before the commencement of MDR-TB therapy. Complete blood count and erythrocyte sedimentation rate (ESR) were determined using an automated haematology analyzer and Westergreen method respectively in 115 patients with MDR-TB. Statistical analysis was done using the Student’s t-test, Mann Whitney U and Chi square as appropriate. P-values less than 0.05 were considered as statistically significant. Twenty-two (19.13%) of the recruited patients had co-infection with HIV. The mean levels of mean corpuscular volume (MCV) and haemoglobin (Hb) were significantly lower in MDR-TB patients compared with patients with MDR-TB/HIV co-infection. The proportion of patients with below reference range (BRR) MCV and mean cell haemoglobin (MCH) was 65% and 73.9% respectively. Similarly, the proportion of patients with BRR haemoglobin (Hb) level was 87% in the two groups with a higher proportion recorded in MDR-TB (90.3%) compared to MDR-TB/HIV co-infection. Also, BRR red cell distribution width (RDW) was recorded in majority (70.4%) of the patients with MDR-TB group having an insignificantly higher proportion (71.0%) compared to MDR-TB co-infection group (68.2%). Treatment naïve patients with MDR-TB have worse CBC findings consistent with iron deficiency anaemia. Hence, assessing haematological parameters before the commencement of MDR-TBtherapy might help in identifying patients that will require appropriate clinical intervention.