HIV and haematopoiesis

HIV and haematopoiesis

Human immunodeficiency virus (HIV) infection not only leads to a compromised immune system, but also disrupts normal haematopoiesis, resulting in the frequent manifestation of cytopenias (anaemia, thrombocytopenia and neutropenia). Although there is a definite association between the severity of cyt...

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Bibliographic Details
Published in:South African medical journal Vol. 109; no. 8 Supplement 1; pp. S41 - S46
Main Authors: Rossouw, T., Khoosal, R., Potgieter, J.C., Herd, C.L., Nel, J.G., Mellet, J., Durandt, C., Pepper, M.S.
Format: Journal Article
Language:English
Published: South Africa Health and Medical Publishing Group (HMPG) 01-08-2019
Health & Medical Publishing Group
Subjects:
Anemia
Anemia - diagnosis
Anemia - etiology
Development and progression
Disease susceptibility
Health aspects
Hematopoiesis
Hematopoietic Stem Cells - cytology
HIV
HIV Infections - complications
HIV patients
Humans
Immune system
Infection
Medical tests
Neutropenia
Neutropenia - diagnosis
Neutropenia - etiology
Stem Cells - cytology
Thrombocytopenia
Thrombocytopenia - diagnosis
Thrombocytopenia - etiology
South Africa
Sub-Saharan Africa
Ethiopia
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Summary:Human immunodeficiency virus (HIV) infection not only leads to a compromised immune system, but also disrupts normal haematopoiesis, resulting in the frequent manifestation of cytopenias (anaemia, thrombocytopenia and neutropenia). Although there is a definite association between the severity of cytopenia and HIV disease stage, this relationship is not always linear. For example, cytopenias such as thrombocytopenia may occur during early stages of infection. The aetiology of these haematological abnormalities is complex and multifactorial, including drug-induced impaired haematopoiesis, bone marrow suppression due to infiltration of infectious agents or malignant cells, HIV-induced impaired haematopoiesis, and several other factors. In this review, we describe the frequencies of anaemia, thrombocytopenia and neutropenia reported for HIV-infected, treatment-naïve cohorts studied in eastern and southern sub-Saharan African countries. We present a rational approach for the use of diagnostic tests during the workup of HIV-infected patients presenting with cytopenia, and discuss how HIV impacts on haematopoietic stem/progenitor cells (HSPCs) resulting in impaired haematopoiesis. Finally, we describe the direct and indirect effects of HIV on HSPCs which result in defective haematopoiesis leading to cytopenias.
ISSN:0256-9574
2078-5135
DOI:10.7196/SAMJ.2019.v109i8b.13829