Staging and haematological abnormalities of HIV-infected persons in the rural Free State Province of South Africa

Abstract

Objectives: The objectives of this study were firstly to determine HIV (human immunodeficiency virus) prevalence in the rural Free State, secondly to classify the stages of HIV by utilising CD4 (cluster of differentiation 4) counts, and thirdly to measure differences in haematological abnormalities between HIV-uninfected and HIV-infected participants.

Method: Blood specimens were obtained from 552 participants in Springfontein (36.3%), Trompsburg (30.1%) and Philippolis (33.5%). Participants were between 25–64 years of age, of which 28.1% were male (mean age 47.3 years) and 71.9% were female (mean age 46.0 years). The primary screening for HIV status was performed using the Enzygnost® HIV Integral II Ag/Ab test and confirmed by the Vironostica® HIV Uni-Form II Ag/Ab test. Full blood counts were performed on all participants, but CD4 counts were only performed on HIV-positive serum.

Results: The overall prevalence of HIV was 17.1%, with the peak prevalence in female participants (41.3%) occurring in the age group of 31–40 years, and in male participants (37.9%) in the age group of 41–50 years. Most HIV-uninfected participants (40.9%) were 51–60 years of age, whilst most HIV-infected participants were 31–40 years (35.6%) of age. The lowest mean CD4 count (276 cells/mm3) was observed in the age group 41–50 years, which was significantly lower than a mean count of 459 cells/mm3 in the age group 31–40 years (p ≤ 0.05). Haemoglobin was significantly reduced in HIV-infected male participants (p < 0.01) and female participants (p < 0.000 1), as ware white blood cell counts (p < 0.001), neutrofil counts (p < 0.005) and lymphocyte counts (p < 0.005). Peak prevalence of HIV in terms of age occurred later (between 31–40 years) than previously described and was reflected by a delayed low CD4 count (41–50 years).

Conclusion: The low CD4 counts and anaemia were probably indicative of a generally ill study population. Participants in need of medical care should be identified and referred for management and follow-up.