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Haematological Changes in HIV
Influence of HIV
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Influence of HIV

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Dr Elza Coetzee - MBChB (US) MMEd (Chem Path) (UFS)

PATHCHAT NO 22: The impact of HIV on Clinical Chemistry

Once upon a time in 1983: 

A colleague describes the night when the first ever “HIV positive” patient encountered caused havoc in a small town hospital casualty. The patient, after learning of his life partner's positive HIV status (a clinical diagnosis at that stage),had taken a long train ride and walked into the casualty department announcing his possible – or rather probable – diagnosis. Rural South Africa was not yet in the know regarding this disease. HIV/AIDS was not in the medical school curriculum, and the Internet was commercially available only after the 90's. The only lead regarding the course of this condition was the patient's announcement of his imminent death due to this unknown virus. Numerous phone calls and long discussions followed, also involving the superintendent, who was just as oblivious to the existence of this virus. The final decision reached was to keep him in isolation overnight, and to put him on the train back to where he came from in the morning…

Today (2010):

The number of HIV positive individuals has increased from 1 million in 1990 to the current estimated 33.2 million worldwide. HIV has changed the face of medicine in South Africa. It has become part of the list of differential diagnoses of almost every immune deficient patient encountered in clinical practice. A diagnosis can be made serologically (from 1985), and confirmatory testing has become more sensitive and sophisticated. Antiretroviral treatment, recently accessible in South Africa, has since presented additional challenges related to treatment.

EFFECTS OF HIV ON CLINICAL CHEMISTRY RESULTS

Interpreting biochemistry results has become a challenging task that requires knowledge and experience regarding the various stages of HIV/AIDS. These different stages have different effects on normal physiology influencing laboratory results, which may confound interpretation. Much has been written on the effects of HIV on laboratory results. The information, however, is somewhat scattered, as single tests or biological systems were investigated, and good review articles are hard to come by.

This article attempts to summarize the common abnormal clinical chemistry results in relation to the different presenting stages of HIV, organ specific HIV disease, and the effects of highly active anti-retroviral treatment (HAART).

 

 

Read the full article here in PDF format.