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

The relationship between HIV-1 replication and hematologic parameters was e xamined in two separate studies. The first study was a cross-sectional eval uation 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 he matologic values (r = -0.266 to -0.331). The second study was a longitudina l evaluation of patients on combination antiretroviral therapy (HAART) with hematologic alterations before treatment (N = 27 with platelets < 150,000/ mul, 24 with hemoglobin < 12 g/dl, 36 with neutrophils < 2000/mul and 29 wi th leukocytes < 3000/mul). 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 all blood cell lineages and became statistically signific ant after the sixth month of therapy (p < .001). Mean values increased from 110 to 180 x 10(3)/mul for platelets, from 10.7 to 12.3 g/dl for hemoglobi n (stabilizing finally at 11.4 g/dl), from 1,260 to 2,240/mul for neutrophi ls, and from 2,260 to 3,600/mul for leukocytes. In conclusion, hematologic disorders are corrected by combination antiretroviral therapy. This suggest s a causative role of HIV-1 in hematologic disorders.