Original articles

HIV and haematopoiesis

C Durandt, JC Potgieter, J Mellet, Candice Herd, R Khoosal, J G Nel, T Rossouw, M S Pepper

Abstract


Human immunodeficiency virus (HIV) infection not only leads to a compromised immune system, but also disrupts normal haematopoiesis, resulting in the frequent manifestation of cytopenias (anaemia, thrombocytopenia and neutropenia). Although there is a definite association between the severity of cytopenia and HIV disease stage, this relationship is not always linear. For example, cytopenias such as thrombocytopenia may occur during early stages of infection. The aetiology of these haematological abnormalities is complex and multifactorial, including drug-induced impaired haematopoiesis, bone marrow suppression due to infiltration of infectious agents or malignant cells, HIV-induced impaired haematopoiesis, and several other factors. In this review, we describe the frequencies of anaemia, thrombocytopenia and neutropenia reported for HIV-infected, treatment-naïve cohorts studied in eastern and southern sub-Saharan African countries. We present a rational approach for the use of diagnostic tests during the workup of HIV-infected patients presenting with cytopenia, and discuss how HIV impacts on haematopoietic stem/progenitor cells (HSPCs) resulting in impaired haematopoiesis. Finally, we describe the direct and indirect effects of HIV on HSPCs which result in defective haematopoiesis leading to cytopenias.


Authors' affiliations

C Durandt, Institute for Cellular and Molecular Medicine, Department of Immunology, Faculty of Health Sciences, University of Pretoria, South Africa; SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, South Africa

JC Potgieter, Department of Haematology, Faculty of Health Sciences, University of Pretoria and National Health Laboratory Service (NHLS), Tshwane Academic Division, Pretoria, South Africa

J Mellet, Institute for Cellular and Molecular Medicine, Department of Immunology, Faculty of Health Sciences, University of Pretoria, South Africa; SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, South Africa

Candice Herd, Institute for Cellular and Molecular Medicine, Department of Immunology, Faculty of Health Sciences, University of Pretoria, South Africa; SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, South Africa

R Khoosal, Department of Haematology, Faculty of Health Sciences, University of Pretoria and National Health Laboratory Service (NHLS), Tshwane Academic Division, Pretoria, South Africa

J G Nel, Department of Haematology, Faculty of Health Sciences, University of Pretoria and National Health Laboratory Service (NHLS), Tshwane Academic Division, Pretoria, South Africa

T Rossouw, Institute for Cellular and Molecular Medicine, Department of Immunology, Faculty of Health Sciences, University of Pretoria, South Africa

M S Pepper, Institute for Cellular and Molecular Medicine, Department of Immunology, Faculty of Health Sciences, University of Pretoria, South Africa; SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, South Africa

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Cite this article

South African Medical Journal 2019;109(8b):40-45. DOI:10.7196/SAMJ.2019.v109i8b.13829

Article History

Date submitted: 2019-09-10
Date published: 2019-09-10

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