HIV-associated hematologic disorders are correlated with plasma viral load and improve under highly active antiretroviral therapy

The relationship between HIV-1 replication and hematologic parameters was examined m two separate studies, The first study was a cross-sectional evaluation of 207 untreated patients. In this study, the proportion of patients with hematologic disorders increased with disease progression. There was a significant inverse correlation between HIV-1 plasma viral load and all hematologic values (r = -0.266 to -0.331). The second study was a longitudinal evaluation of patients on combination antiretroviral therapy (HAART) with hematologic alterations before treatment (N = 27 with platelets <150,000/μl, 24 with hemoglobin <12 g/dl, 36 with neutrophils <2000/μ1 and 29 with leukocytes <3000/μl). Samples were analyzed every 3 months for 2 years. At 2 years, >50% of patients experienced a sustained virologic response, with viral loads <500 RNA copies/ml. Hematologic reconstitution occurred progressively for ail blood cell lineages and became statistically significant after the sixth month of therapy (p < .001). Mean values increased from 110 to 180 × 103/μl for platelets, from 10.7 to 12.3 g/dl for hemoglobin (stabilizing finally at 11.4 g/dl), from 1,260 to 2,240/μ1 for neutrophils, and from 2,260 to 3,600/μ1 for leukocytes. In conclusion, hematologic disorders are corrected by combination antiretroviral therapy. This suggests a causative role of HIV-1 in hematologic disorders.