Context: Bone marrow abnormalities reported in various stages of HIV infection have not attracted much attention; this is partly because the clinical picture of HIV infection is still dominated by opportunistic infections and malignancies.
Aims: 1. To study the bone marrow abnormalities in patients with HIV / AIDS and to find their association with peripheral hematological abnormalities. 2. To draw conclusions and compare with previous studies.
Settings and Design: The present Prospective study was conducted at the Department of pathology, Kamineni Institute of Medical Sciences, Narketpalli over a period of 2 years starting from January 2017 to Dec 2018.
Methods and Material: The study population included 54 newly detected HIV positive symptomatic or asymptomatic patients. Patients were classified into two clinical groups according to NACO criteria 1) AIDS and 2) Non-AIDS. Bone marrow analysis was done for HIV patients who presented with anemia, leucopenia, Thrombocytopenia and Bi-cytopenia.
Results: Patients were classified into two clinical groups: AIDS (55.5%) and NON-AIDS (44.5%). Most common age group involved was 21-40 years and Male to Female ratio is 4:1 in AIDS Group and 1.6:1 in Non-AIDS group. Most common haematological abnormality was Anaemia present in 73.3% of AIDS group and 79.1% of Non-AIDS group. Bone marrow was predominantly normocellular (AIDS: 50%, Non-AIDS: 62.5%) with normoblastic maturation. Myelodysplasia was predominantly seen in Granulocytic series (AIDS: 26.6%, Non-AIDS: 12.5%). Erythroid dysplasia was reported in 23.3% of cases of AIDS group and 8.3% in Non-AIDS group. Megakaryocytic dysplasia was seen in 2 cases of AIDS group. Myelodysplasia was common in patients with CD4 counts < 200/µL. Patients with myelodysplasia presented with anaemia (52.9%), Leukopenia (41.1%) and Thrombocytopenia (11.7%).
Conclusions: Bone marrow examination is usually performed in HIV patients to evaluate peripheral cytopenia. Myelodysplasia commonly observed in HIV patients predominantly involves Granulocytic series. Erythroid dysplasia is prominent in AIDS Patients. Myelodysplasia associated with anemia carries poor prognosis and marks progression to advanced disease. Bone marrow abnormalities evolve and increase in frequency during progression of HIV disease and thorough schematic evaluation carries prognostic significance.