Original Article Hematological Abnormalities among HIV/AIDS Patients on Zidovudine Containing Anti-retroviral Therapy

Background: Ziduvudine is notorious for causing hematological abnormalities, especially severe bone marrow toxicity manifested as anemia, macrocytosis and neutropenia. Objectives: To assess the haematological abnormalities among patients on Ziduvudine containing highly active anti-retroviral therapy (HAART). Materials and methods: This descriptive observational study was carried out at HIV AIDS treatment and care centre PIMS, Islamabad. An analysis was based on 189 randomly selected patients who were found eligible for HAART. Results: Out of 369 diagnosed cases of HIV/AIDS, 189 were found to be eligible for ARV (Anti-retroviral therapy). Initially 174 patients (65.60%) were put on Zidovudine as part of first line ARV regimen, 11 patients (5.82%) on Stavudine and 4 patients (2.11%) on second line ARVs. Out of 174 patients, 100 patients were randomly selected and were followed up to see anemia, pancytopenia and macrocytosis after 6 months of initiation of therapy. Fifteen per cent patients developed anemia, 76 % had no anemia and 9 % had no follow up. Macrocytosis was observed in 6 patients. Out of six patients who underwent bone marrow biopsy, two had aplastic anemia the others revealed variable degree of megakaryocytic and/or erythroid hypoplasia. Surprisingly among patients on Stavudine no patient developed anemia. Conclusion: Zidovudine is known to cause anemia and close follow up of the patients is required while on treatment