Morphological study of bone marrow in HIV/AIDS patients with anaemia

Abstract

Background and Objectives : Human immunodeficiency virus can involve almost any organ system. Bone marrow changes include varying degree of dysplasia in one or more cell lines, plasmacytosis, granuloma and bone marrow necrosis. Anaemia has been found to be the most common hematological manifestation in HIV/AIDS patients. Hence, present study was aimed to study the bone marrow morphology in HIV infected anaemic patients and to evaluate iron stores. Materials and Methods : Seventy five HIV positive patients haemoglobin ? 10 gm/dl and aged between 18-58 years were taken. Complete hemogram and CD4+ counts were done in all patients and were classified as those having AIDS and Non AIDS, according to NACO criteria. Written informed consent was taken from patients and bone marrow aspiration was done from posterior superior iliac spine. Smears were stained with Leishman stain for morphological study and Perls Prussian blue for iron stores. Results: Total patients included in the study were 75. Majority of patients had normocytic normochromic anaemia. Normocellular bone marrow was most common seen in 63.66% patients. Dysplasia was seen in 76%, being more common in AIDS than Non AIDS. Erythroid dysplasia was the most common dysplasia seen in 68%. Granuloma was seen in one case. Iron stores were found to be adequate in majority of patients. Conclusion: Normocytic normochromic anaemia was the most common peripheral smear finding. Hypocellular bone marrow was more common than hypercellular marrow in advanced stage of disease. Dysplastic changes were more common in AIDS than Non AIDS. Erythroid dysplasia was the most common type of dysplasia. Iron stores were adequate in most of the cases as in anaemia of chronic disease.