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GLUCOSE-6-PHOSPHATE DEHYDROGENASE, PYRUVATE KINASE LEVELS AND SOME HAEMATOLOGICAL PARAMETERS IN HIV PATIENTS ON ART AT NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL

ABSTRACT

This study was designed to assess Glucose-6-Phosphate Dehydrogenase, Pyruvate kinase enzyme activity and some haematological parameters in HIV positive patients on antiretroviral treatment (ART) and those not on antiretroviral treatments. One hundred and eighty one (181) subjects were recruited for this study; Sixty (30 males and 30 females) were HIV seropositive subjects on antiretroviral therapy (ART) (group A), Sixty (25 males and 35 females) were HIV seropositive subjects not on ART (group B) and Sixty-one (31 male and 30 female) apparently healthy individuals served as control subjects (group C). The study subjects were tested for Human Immunodeficiency virus (HIV) screening, Glucose-6-Phosphate Dehydrogenase (G-6-PD), Pyruvate kinase (PK), Activated Partial Thromboplastin time (APTT), Prothrombin time (PT), Platelet count (PLT), CD4 count, Total white cell count (TWBC), differential white cell count (NEUT, LYM, MXD), Reticulocytes count, Packed cell volume (PCV), Haemoglobin (HGB), Red blood cell count (RBC), Mean cell volume (MCV), Mean cell haemoglobin (MCH) and Mean cell haemoglobin concentration (MCHC) after obtaining ethical approval for the study and informed consent of the subjects. G-6-PD assay was carried out by the Spectrophotometric

method (using Randox kit), the PK assay was done by ELISA technique using Micro-plate reader, CD4 count was done using Cyflow counter, Sysmex auto-analyzer was used for Full blood count and red cell indices, PT was done using the citrated blood and calcium-thromboplastin method, APTT was done using the calcium-chloride and kaolin-platelet substitute method while HIV test was done using immunochromatographic test strips.

ANOVA and t-test were used for statistical analysis. The results showed that G-6-PD, APTT, PT, MXD, MCV, MCH for group A and B were significantly higher (F = 28.57; 57.98; 33.88; 16.05; 206.45; 100.44; P < 0.05 respectively) compared with control group C. CD4 count, HGB, RBC, MCHC of group A and B were significantly lower (F = 39.39; 8.51; 133.85; 33.32; P<0.05 respectively) compared with control group. TWBC and NEUT were higher in group B compared with the control group (P<0.05). G-6-PD, PT, MCV were significantly higher in group A compared with group B (P < 0.05) while TWBC and LYM were significantly reduced in group A compared with group B (P<0.05). There was no significant difference in Pyruvate kinase activity for the three groups (F = 1.90; P>0.05). This study identified a significant increase in G-6-PD activity in HIV patients with the absence of anaemia and reticulocytosis. APTT and PT were also significantly increased in HIV patients.

 

CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

Human Immunodeficiency Virus (HIV) has emerged a global disaster

ever since its discovery (WHO, 2009). HIV/AIDS continues to spread

globally and remains a worldwide pandemic affecting over 40 million

people (Maplanka, 2007; Willey et al., 2008). The population affected

by HIV in Africa especially sub-Saharan Africa is about 70% (Kumar et

al., 2006). It is now the leading cause of death in sub-Saharan Africa

and the fourth leading cause of mortality worldwide and over 95% of these deaths have occurred among young adults in the developing world (Guatelli et al., 2002; USAID, 2008). The net consequences of the disease is a gradual depletion of a subpopulation of the Tlymphocyte called the T-helper cells (with genetic marker CD4) that plays an important role in immune defense system of the host, its depletion leaves the patients susceptible to various opportunistic infections, malignancies, anaemia and death (Okolie, et al., 2003).

Highly active antiretroviral therapy (HAART) has generally been taken as the gold standard in the management of HIV patients (Odunukwe et al., 2005). With its introduction in 1996, HAART appears to have effectively controlled viral replication in HIV/AIDS patients and has successfully improved their quality of life and prolonged their lifeexpectancy

(De-larranaga et al., 2003; Jacobson et al., 2004), with a near normal turnover of both CD4 and CD8 T-cell populations (Silvestri and Feinberg, 2003; Torti et al., 2004; Simon et al., 2006). Anaemia is a clinical condition in which the number or red blood cells and oxygen carrying capacity of blood is reduced. It is usually a sign of an underlying disease and may be mild or severe (Ochei and Kolhatkar, 2000).It may be due to a number of causes which includes ...Get Complete Material.


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