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Haematology International Journal Research Article 19 min read

Antiretroviral Therapy and Red Blood Cell Morphology: A Review in HIV Patients

Emmanuel Ifeanyi Obeagu*, Getrude Uzoma Obeagu and Matthew Chibunna Igwe
* Corresponding author
ISSN: 2578-501X  10.23880/hij-16000233  Received: February 12, 2024  Published: February 21, 2024
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Keywords
Antiretroviral Therapy Red Blood Cells HIV Hematological Consequences Erythrocyte Abnormalities Clinical Implications
Abstract

Antiretroviral therapy (ART) has transformed the management of HIV, significantly improving the prognosis and quality of life for individuals living with the virus. While the primary focus of ART has traditionally been on viral suppression and immune restoration, emerging evidence suggests a potential impact on red blood cell (RBC) morphology. This paper explores the intricate relationship between antiretroviral therapy and red blood cell morphology in HIV patients, shedding light on the multifaceted effects of these medications beyond their antiviral properties. Moving beyond laboratory findings, the review investigates the clinical implications of alterations in red blood cell morphology in individuals undergoing antiretroviral therapy. This includes discussions on potential implications for oxygen-carrying capacity, hemoglobin levels, and overall hematological health, emphasizing the need for a holistic understanding of the hematopoietic consequences of ART. In conclusion, this paper consolidates existing knowledge, identifies gaps in understanding, and provides a comprehensive resource for researchers, clinicians, and healthcare professionals involved in the care of HIV patients. It contributes to the broader conversation on the holistic effects of antiretroviral therapy, paving the way for future investigations and improved clinical management.

Emmanuel Ifeanyi Obeagu1*, Getrude Uzoma Obeagu2 and Matthew Chibunna Igwe3

Introduction

Human Immunodeficiency Virus (HIV) infection remains a global public health challenge, affecting millions of individuals worldwide. The advent of Antiretroviral Therapy (ART) has revolutionized the management of HIV, leading to substantial reductions in morbidity and mortality. While the primary focus of ART has traditionally been on suppressing viral replication and restoring immune function, emerging evidence suggests that these medications may have implications beyond their antiviral effects. This comprehensive review aims to explore the intricate relationship between antiretroviral therapy and red blood cell (RBC) morphology in HIV patients, shedding light on an aspect of treatment that extends beyond viral control [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15]. HIV, a retrovirus that primarily targets the immune system, has necessitated the development of sophisticated antiretroviral regimens to control viral replication. The success of ART in achieving and maintaining viral suppression has transformed HIV into a chronic, manageable condition. However, as individuals with HIV now experience increased life expectancy, attention is turning to the broader impact of long-term ART on various physiological systems, including the hematological profile [16, 17, 18, 19, 20, 21, 22, 23, 24, 25].

Red blood cells, critical components of the circulatory system, play a pivotal role in oxygen transport and overall physiological homeostasis. While the influence of HIV on hematopoiesis and red blood cell parameters has been studied, the specific effects of antiretroviral therapy on RBC morphology remain an area of growing interest and investigation [26, 27, 28, 29, 30]. Understanding the mechanisms underlying ART-induced changes in red blood cell morphology is crucial for unraveling the complex interplay between antiretroviral drugs and erythrocytes. This review explores potential pathways, ranging from direct effects on erythropoietic precursors to interactions with iron metabolism, providing a comprehensive understanding of the hematopoietic consequences of ART [31, 32, 33, 34, 35]. Moving beyond laboratory findings, the review investigates the clinical implications of alterations in red blood cell morphology for individuals undergoing antiretroviral therapy. This includes discussions on potential impacts on oxygen-carrying capacity, hemoglobin levels, and overall hematological health, emphasizing the need for a holistic understanding of the hematopoietic consequences of ART.

Aim

The aim of this paper is to comprehensively examine the influence of antiretroviral therapy (ART) on red blood cell (RBC) morphology in individuals living with HIV.

Antiretroviral Drugs and their Influence on Red Blood Cells

Antiretroviral therapy (ART) has been a cornerstone in the management of HIV, significantly improving patient outcomes. While the primary goal of ART is to suppress viral replication and enhance immune function, there is a growing body of evidence suggesting potential interactions between antiretroviral drugs and red blood cells (RBCs) [36, 37, 38, 39, 40]. Nucleoside Reverse Transcriptase Inhibitors (NRTIs), such as zidovudine, stavudine, and tenofovir, form a critical component of many ART regimens. Studies indicate that certain NRTIs may affect erythropoiesis, leading to changes in RBC parameters. Zidovudine, in particular, has been associated with macrocytosis and anemia, highlighting the need for close monitoring of hematological parameters in individuals on NRTI-based regimens [41, 42, 43, 44, 45, 46].

Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs), including efavirenz and nevirapine, have demonstrated efficacy in suppressing viral replication. While these drugs are generally well-tolerated, there is emerging evidence suggesting potential effects on red blood cell morphology [41].

Protease inhibitors, such as ritonavir and atazanavir, play a crucial role in inhibiting viral maturation. Some Protease Inhibitors (PIs) have been associated with hyperbilirubinemia and indirect hyperbilirubinemia, potentially impacting RBC dynamics. Integrase Strand Transfer Inhibitors (INSTIs), represented by drugs like dolutegravir and raltegravir, have gained prominence in HIV treatment regimens. While the focus has been on their antiviral efficacy, recent studies have suggested potential links between INSTIs and alterations in hematological parameters, including RBC indices [42]. Less commonly used but important in specific cases, CCR5 antagonists (e.g., maraviroc) and fusion inhibitors (e.g., enfuvirtide) also warrant consideration regarding their influence on RBC morphology.

Mechanisms Underlying ART-Induced Changes in RBC Morphology

Some antiretroviral drugs, particularly zidovudine, have been associated with myelosuppression, potentially affecting the normal process of erythropoiesis. This disruption in bone marrow function may lead to changes in RBC production and morphology. Nucleoside Reverse Transcriptase Inhibitors (NRTIs) have been linked to mitochondrial toxicity, particularly affecting the respiratory chain. As mitochondria play a crucial role in erythropoiesis, any compromise in their function may contribute to altered RBC morphology.41 Certain antiretroviral drugs may have a direct impact on the erythrocyte membrane. For instance, protease inhibitors (PIs) have been associated with changes in membrane fluidity and integrity, potentially influencing RBC morphology. Some protease inhibitors, such as atazanavir, can lead to indirect hyperbilirubinemia. Elevated bilirubin levels may affect iron metabolism, influencing erythropoiesis and contributing to changes in RBC parameters. In rare instances, antiretroviral drugs may induce immune-mediated hemolytic anemia. This phenomenon involves the immune system targeting and destroying RBCs, leading to alterations in red blood cell morphology. Some antiretroviral drugs may contribute to oxidative stress within the erythrocytes, leading to the accumulation of reactive oxygen species. Oxidative damage can impact membrane structure and function, influencing RBC morphology.

Drug-drug interactions, especially in the context of polypharmacy in individuals with HIV, may contribute to changes in RBC morphology. For instance, interactions between antiretroviral drugs and medications affecting hematopoiesis may influence erythrocyte parameters [47, 48, 49, 50, 51]. Anemia is a common side effect of certain antiretroviral drugs, and its occurrence can be multifactorial. The impact on erythrocyte parameters and morphology may be a direct result of the hematological side effects induced by these medications. The inherent properties of specific antiretroviral drugs, such as their chemical structure and mechanism of action, may contribute to changes in RBC morphology. Understanding the unique characteristics of each drug is essential for deciphering their impact on erythrocytes. Host factors, including genetic predispositions and individual variations in drug metabolism, may play a role in determining the extent of ART-induced changes in RBC morphology. Understanding the interplay between host factors and antiretroviral drugs is crucial for a comprehensive assessment [52, 53, 54, 55].

Clinical Implications of ART-Induced Changes in RBCs

Clinicians should integrate regular hematologic monitoring, including complete blood counts, into the care of individuals on ART. This allows for the early detection of changes in RBC parameters, enabling timely interventions and adjustments to the antiretroviral regimen. Recognition of ART-induced anemia is crucial for appropriate management [56]. Tailored interventions, such as adjustments in drug regimens or the administration of erythropoiesis-stimulating agents, may be necessary to mitigate anemia and improve overall hematological health. Changes in RBC parameters can influence cardiovascular risk. Clinicians should consider the potential impact of ART-induced alterations on factors such as hemoglobin levels and RBC morphology when assessing cardiovascular risk in individuals living with HIV [57, 58, 59, 60, 61]. Understanding the influence of ART on RBC parameters is essential for assessing oxygen-carrying capacity. Clinicians need to be vigilant about potential implications for tissue oxygenation and overall physiological functioning, particularly in individuals with pre-existing cardiovascular or respiratory conditions [62, 63, 64, 65].

Recognizing the hematological consequences of specific antiretroviral drugs allows for the development of more individualized treatment plans. Clinicians can choose regimens that minimize adverse effects on RBCs, taking into consideration the patient’s overall health and comorbidities. Certain antiretroviral drugs may impact iron metabolism, potentially leading to imbalances and contributing to changes in RBC morphology. Regular monitoring of iron status and appropriate supplementation may be necessary to address these effects. Educating patients about potential hematological side effects is essential for managing expectations and promoting adherence to ART. Clear communication regarding the possibility of changes in RBC parameters can empower patients to report symptoms promptly and seek timely medical attention [66, 67, 68]. Awareness of the potential for drug-induced immune hemolytic anemia (DIIHA) is crucial. Clinicians should carefully monitor for signs of hemolysis and promptly address immune-mediated reactions to prevent severe complications associated with RBC destruction [68]. For individuals experiencing significant hematological side effects, collaboration with hematologists may be beneficial. A multidisciplinary approach ensures comprehensive management, with hematologists contributing their expertise in addressing complex hematological conditions. Recognizing that changes in RBC parameters may evolve over time, long-term follow-up is essential. Regular assessments of hematological parameters during the course of ART allow for ongoing management and adjustment of treatment plans as needed [69, 70, 71].

Recommendations

Implement routine hematologic monitoring, including complete blood counts, for individuals on antiretroviral therapy (ART) to detect changes in red blood cell parameters early. Consider the hematological profile of specific antiretroviral drugs when designing treatment regimens. Tailor therapy based on the patient’s overall health, comorbidities, and potential impact on red blood cells. Develop strategies for the early identification and management of ART-induced anemia. Adjustments in drug regimens or the use of erythropoiesis-stimulating agents may be necessary to mitigate anemia. Incorporate consideration of ART-induced changes in red blood cell parameters when assessing cardiovascular risk in individuals living with HIV. Educate patients about potential hematological side effects of ART, including changes in red blood cells. Promote adherence to treatment by managing patient expectations and providing clear communication. Monitor iron status in individuals on ART, especially for those receiving drugs associated with potential effects on iron metabolism. Consider appropriate supplementation based on monitoring results.

Foster collaboration between HIV specialists and hematologists to manage individuals with significant hematological side effects. A multidisciplinary approach ensures comprehensive care for complex hematological conditions. Implement long-term follow-up assessments for individuals on ART to monitor changes in red blood cell parameters over time. Adjust treatment plans as needed based on evolving hematologic profiles. Assess the risk of immune-mediated reactions, including drug-induced immune hemolytic anemia (DIIHA). Monitor for signs of hemolysis and promptly address immune-mediated reactions to prevent severe complications. Explore novel therapeutic interventions that may mitigate adverse hematological effects of ART, such as targeted agents that counteract mitochondrial toxicity or modulate immune- mediated responses. Conduct patient-centered outcome research to assess the impact of ART-induced changes in red blood cells on quality of life, fatigue, and overall well-being. Consider patient-reported outcomes in addition to objective hematological measures.

Conclusion

The relationship between antiretroviral therapy (ART) and red blood cell (RBC) morphology in individuals living with HIV is a complex and multifaceted area that warrants careful consideration. This comprehensive review has delved into the diverse mechanisms underlying ART-induced changes in RBCs and the resulting clinical implications. The clinical implications of ART-induced changes in RBCs extend beyond laboratory values, impacting cardiovascular risk assessment, oxygen-carrying capacity, and overall physiological well- being. By integrating hematologic considerations into routine clinical practice, healthcare providers can optimize treatment outcomes and enhance the overall health of individuals living with HIV.

References

  1. Obeagu EI, Okwuanaso CB, Edoho SH, Obeagu GU (2022) Under-nutrition among HIV-exposed Uninfected Children: A Review of African Perspective. Madonna University journal of Medicine and Health Sciences 2(3): 120-127.
  2. Obeagu EI, Alum EU, Obeagu GU (2023) Factors associated with prevalence of HIV among youths: A review of Africa perspective. Madonna University journal of Medicine and Health Sciences 3(1): 13-18.
  3. Obeagu EI (2023) A Review of Challenges and Coping Strategies Faced by HIV/AIDS Discordant Couples. Madonna University journal of Medicine and Health Sciences 3(1): 7-12.
  4. Obeagu EI, Obeagu GU (2023) An update on premalignant cervical lesions and cervical cancer screening services among HIV positive women. J Pub Health Nutri 6(2): 141.
  5. Ezeoru VC, Enweani IB, Ochiabuto O, Nwachukwu AC, Obeagu EI, et al. (2021) Prevalence of Malaria with Anaemia and HIV status in women of reproductive age in Onitsha, Nigeria. Journal of Pharmaceutical Research International 33(4): 10-19.
  6. Emmanuel OUK, Chinedum OK, Obeagu EI (2017) Evaluation of laboratory logistics management information system in HIV/AIDS comprehensive health facilities in Bayelsa State, Nigeria. Int J Curr Res Med Sci 3(1): 21-38.
  7. Obeagu EI, Obeagu GU, Musiimenta E, Bot YS, Hassan AO (2023) Factors contributing to low utilization of HIV counseling and testing services. Int J Curr Res Med Sci 9(2): 1-5.
  8. Obeagu EI, Obeagu GU (2022) An update on survival of people living with HIV in Nigeria. J Pub Health Nutri 5(6): 129.
  9. Offie DC, Obeagu EI, Akueshi C, Njab JE, Ekanem EE, et al. (2021) Facilitators and barriers to retention in HIV care among HIV infected MSM attending Community Health Center Yaba, Lagos Nigeria. Journal of Pharmaceutical Research International 33(52B): 10-19.
  10. Obeagu EI, Ogbonna US, Nwachukwu AC, Ochiabuto O, Enweani IB, et al. (2021) Prevalence of Malaria with Anaemia and HIV status in women of reproductive age in Onitsha, Nigeria. Journal of Pharmaceutical Research International 33(4): 10-19.
  11. Odo M, Ochei KC, Obeagu EI, Barinaadaa A, Eteng UE, et al. (2020) TB Infection Control in TB/HIV Settings in Cross River State, Nigeria: Policy Vs Practice. Journal of Pharmaceutical Research International 32(22): 101- 119.
  12. Obeagu EI, Eze VU, Alaeboh EA, Ochei KC (2016) Determination of haematocrit level and iron profile study among persons living with HIV in Umuahia, Abia State, Nigeria. J BioInnovation 5: 464-471.
  13. Ifeanyi OE, Obeagu GU (2015) The values of prothrombin time among HIV positive patients in FMC owerri. International Journal of Current Microbiology and Applied Sciences 4(4): 911-916.
  14. Izuchukwu IF, Ozims SJ, Agu GC, Obeagu EI, Onu I, et al. (2016) Knowledge of preventive measures and management of HIV/AIDS victims among parents in Umuna Orlu community of Imo state Nigeria. Int J Adv Res Biol Sci 3(10): 55-65.
  15. Chinedu K, Takim AE, Obeagu EI, Chinazor UD, Eloghosa O, et al. (2017) HIV and TB co-infection among patients who used Directly Observed Treatment Short-course centres in Yenagoa, Nigeria. IOSR J Pharm Biol Sci 12(4): 70-75.
  16. Oloro OH, Oke TO, Obeagu EI (2022) Evaluation of Coagulation Profile Patients with Pulmonary Tuberculosis and Human Immunodeficiency Virus in Owo, Ondo State, Nigeria. Madonna University journal of Medicine and Health Sciences 2(3): 110-119.
  17. Nwosu DC, Obeagu EI, Nkwocha BC, Nwanna CA, Nwanjo HU, et al. (2016) Change in Lipid Peroxidation Marker (MDA) and Non enzymatic Antioxidants (VIT C & E) in HIV Seropositive Children in an Urban Community of Abia State. Nigeria. J Bio Innov 5(1): 24-30.
  18. Igwe CM, Obeagu IE, Ogbuabor OA (2022) Clinical characteristics of people living with HIV/AIDS on ART in 2014 at tertiary health institutions in Enugu, Nigeria. J Pub Health Nutri 5(6): 130.
  19. Ifeanyi OE, Obeagu GU, Ijeoma FO, Chioma UI (2015) The values of activated partial thromboplastin time (APTT) among HIV positive patients in FMC Owerri. Int J Curr Res Aca Rev 3: 139-144.
  20. Obiomah CF, Obeagu EI, Ochei KC, Swem CA, Amachukwu BO (2018) Hematological indices o HIV seropositive subjects in Nnamdi Azikiwe University teaching hospital (NAUTH), Nnewi. Ann Clin Lab Res 6(1): 1-4.
  21. Emmanuel OUK, Ochei KC, Osuala EO, Obeagu EI, Onwuasoanya UF (2017) Impact of prevention of mother to child transmission (PMTCT) of HIV on positivity rate in Kafanchan, Nigeria. Int J Curr Res Med Sci 3(2): 28-34.
  22. Aizaz M, Abbas FA, Abbas A, Tabassum S, Obeagu EI (2023) Alarming rise in HIV cases in Pakistan: Challenges and future recommendations at hand. Health Science Reports 6(8): e1450.
  23. Obeagu EI, Amekpor F, Scott GY (2023) An update of human immunodeficiency virus infection: Bleeding disorders. J Pub Health Nutri 6(1): 139.
  24. Obeagu EI, Scott GY, Amekpor F, Ofodile AC, Edoho SH, et al. (2022) Prevention of New Cases of Human Immunodeficiency Virus: Pragmatic Approaches of Saving Life in Developing Countries. Madonna University journal of Medicine and Health Sciences 2(3): 128-134.
  25. Walter O, Anaebo QB, Obeagu EI, Okoroiwu IL (2022) Evaluation of Activated Partial Thromboplastin Time and Prothrombin Time in HIV and TB Patients in Owerri Metropolis. Journal of Pharmaceutical Research International 34(3A): 29-34.
  26. Odo M, Ochei KC, Obeagu EI, Barinaadaa A, Eteng EU, (2020) Cascade variabilities in TB case finding among people living with HIV and the use of IPT: assessment in three levels of care in cross River State, Nigeria. Journal of Pharmaceutical Research International 32(24): 9-18.
  27. Jakheng SP, Obeagu EI (2022) Seroprevalence of human immunodeficiency virus based on demographic and risk factors among pregnant women attending clinics in Zaria Metropolis, Nigeria. J Pub Health Nutri 5(8): 137.
  28. Obeagu EI, Obeagu GU (2023) A Review of knowledge, attitudes and socio-demographic factors associated with non-adherence to antiretroviral therapy among people living with HIV/AIDS. Int J Adv Res Biol Sci 10(9): 135- 142.
  29. Obeagu EI, Onuoha EC (2023) Tuberculosis among HIV Patients: A review of Prevalence and Associated Factors. Int J Adv Res Biol Sci 10(9): 128-134.
  30. Obeagu EI, Ibeh NC, Nwobodo HA, Ochei KC, Iwegbulam CP (2017) Haematological indices of malaria patients coinfected with HIV in Umuahia. Int J Curr Res Med Sci 3(5): 100-104.
  31. Jakheng SP, Obeagu EI, Abdullahi IO, Jakheng EW, Chukwueze CM, et al. (2022) Distribution Rate of Chlamydial Infection According to Demographic Factors among Pregnant Women Attending Clinics in Zaria Metropolis, Kaduna State, Nigeria. South Asian Journal of Research in Microbiology 13(2): 26-31.
  32. Viola N, Kimono E, Nuruh N, Obeagu EI (2023) Factors Hindering Elimination of Mother to Child Transmission of HIV Service Uptake among HIV Positive Women at Comboni Hospital Kyamuhunga Bushenyi District. Asian Journal of Dental and Health Sciences 3(2): 7-14.
  33. Okorie HM, Obeagu EI, Okpoli HCH, Chukwu SN (2020) Comparative study of enzyme linked immunosorbent assay (Elisa) and rapid test screening methods on HIV, Hbsag, Hcv and Syphilis among voluntary donors in. Owerri, Nigeria. J Clin Commun Med 2(3): 180-183.
  34. Ezugwu UM, Onyenekwe CC, Ukibe NR, Obeagu EI, Emeje PI, et al. (2021) Use of ATP, GTP, ADP and AMP as an Index of Energy Utilization and Storage in HIV Infected Individuals at NAUTH, Nigeria: A Longitudinal, Prospective, Case-Controlled Study. Journal of Pharmaceutical Research International 33(47A): 78-84.
  35. Emannuel G, Martin O, Peter OS, Obeagu EI, Daniel K (2023) Factors Influencing Early Neonatal Adverse Outcomes among Women with HIV with Post Dated Pregnancies Delivering at Kampala International University Teaching Hospital, Uganda. Asian Journal of Pregnancy and Childbirth 6(1): 203-211.
  36. Igwe MC, Obeagu EI, Ogbuabor AO, Eze GC, Ikpenwa JN, et al. (2020) Socio-Demographic Variables of People Living with HIV/AIDS Initiated on ART in 2014 at Tertiary Health Institution in Enugu State. Asian Journal of Research in Infectious Diseases 10(4): 1-7.
  37. Vincent CC, Obeagu EI, Agu IS, Ukeagu NC, Onyekachi CAC (2021) Adherence to Antiretroviral Therapy among HIV/AIDS in Federal Medical Centre, Owerri. Journal of Pharmaceutical Research International 33(57A): 360- 368.
  38. Igwe MC, Obeagu EI, Ogbuabor AO (2022) Analysis Of The Factors And Predictors Of Adherence To Healthcare Of People Living With Hiv/Aids In Tertiary Health Institutions In Enugu State. Madonna University journal of Medicine and Health Sciences 2(3): 42-57.
  39. Madekwe CC, Madekwe CC, Obeagu EI (2022) Inequality of monitoring in Human Immunodeficiency Virus, Tuberculosis and Malaria: A Review. Madonna University journal of Medicine and Health Sciences 2(3): 6-15.
  40. Echendu GE, Vincent CC, Ibebuike J, Asodike M, Obeagu EI (2023) Weights Of Infants Born To Hiv Infected Mothers: A Prospective Cohort Study In Federal Medical Centre, Owerri, Imo State. European Journal of Pharmaceutical and Medical Research 10(8): 564-568.
  41. Kufel WD, Hale CM, Sidman EF, Orellana CE, Miller CD (2016) Nucleoside reverse transcriptase inhibitor (NRTI) associated macrocytosis. Int J Virol AIDS 3: 18.
  42. Poz D, De FE, Pisano C, Madonna R, Ferdinandy P, et al. Diagnostic and prognostic relevance of red blood cell distribution width for vascular aging and cardiovascular diseases. Rejuvenation Research 22(2): 146-162.
  43. Nwosu DC, Nwanjo HU, Okolie NJ, Obeagu EI, Nnatunanya I, et al. (2015) Biochemical Alterations In Adult Hiv Patients On Antiretrqviral Therapy. World Journal of Pharmacy and Pharmaceutical Sciences 4(3): 153-160**.**
  44. Obeagu EI, Obeagu GU (2015) Effect of CD4 Counts on Coagulation Parameters among HIV Positive Patients in Federal Medical Centre, Owerri, Nigeria. Int J Curr Res Biosci Plant Biol 2(4): 45-49.
  45. Obeagu EI, Nwosu DC (2019) Adverse drug reactions in HIV/AIDS patients on highly active antiretro viral therapy: a review of prevalence. Int J Curr Res Chem Pharm Sci 6(12): 45-48.
  46. Obeagu EI, Scott GY, Amekpor F, Obeagu GU (2023) Implications of CD4/CD8 ratios in Human Immunodeficiency Virus infections. Int J Curr Res Med Sci 9(2): 6-13.
  47. Obeagu EI, Ochei KC, Okeke EI, Anode AC (2016) Assessment of the level of haemoglobin and erythropoietin in persons living with HIV in Umuahia. Int J Curr Res Med Sci 2(4): 29-33.
  48. Ifeanyi OE, Obeagu GU (2015) The Values of CD4 Count, among HIV Positive Patients in FMC Owerri. Int J Curr Microbiol App Sci 4(4): 906-910.
  49. Obeagu EI, Okeke EI, Anonde AC (2016) Evaluation of haemoglobin and iron profile study among persons living with HIV in Umuahia, Abia state, Nigeria. Int J Curr Res Biol Med 1(2): 1-5.
  50. Alum EU, Ugwu OP, Obeagu EI, Okon MB (2023) Curtailing HIV/AIDS Spread: Impact of Religious Leaders. Newport International Journal of Research in Medical Sciences (NIJRMS) 3(2): 28-31.
  51. Obeagu EI, Obeagu GU, Paul CUO (2023) Stigma Associated With HIV. AIDS: A Review. Newport International Journal of Public Health and Pharmacy (NIJPP) 3(2): 64-67.
  52. Alum EU, Obeagu EI, Ugwu OP, Aja PM, Okon MB (2023) HIV Infection and Cardiovascular diseases: The obnoxious Duos. Newport International Journal of Research in Medical Sciences (NIJRMS) 3(2): 95-99.
  53. Ibebuike JE, Nwokike GI, Nwosu DC, Obeagu EI (2018) A Retrospective Study on Human Immune Deficiency Virus among Pregnant Women Attending Antenatal Clinic in Imo State University Teaching Hospital. International Journal of Medical Science and Dental Research 1 (2): 8-14.
  54. Obeagu EI, Obarezi TN, Omeh YN, Okoro NK, Eze OB (2014) Assessment of some haematological and biochemical parametrs in HIV patients before receiving treatment in Aba, Abia State, Nigeria. Res J Pharma Biol Chem Sci 5: 825-830.
  55. Obeagu EI, Obarezi TN, Ogbuabor BN, Anaebo QB, Eze GC (2014) Pattern of total white blood cell and differential count values in HIV positive patients receiving treatment in Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria. International Journal of Life Science, Biotechnology and Pharama Research 391: 186-189.
  56. Mahajan VK, Dhattarwal N, Mehta KS, Chauhan PS, Sharma A, et al, (2023) Prevalence of anemia among HIV-infected individuals and the associated factors: A single-center, retrospective review of 513 cases. Our Dermatology Online/Nasza Dermatologia Online 14(1): 23-28
  57. Oloro OH, Obeagu EI (2022) A Systematic Review on Some Coagulation Profile in HIV Infection. International Journal of Innovative and Applied Research 10(5): 1-11.
  58. Nwosu DC, Obeagu EI, Nkwuocha BC, Nwanna CA, Nwanjo HU, et al. (2015) Alterations in superoxide dismutiase, vitamins C and E in HIV infected children in Umuahia, Abia state. International Journal of Advanced Research in Biological Sciences 2(11): 268-271.
  59. Obeagu EI, Malot S, Obeagu GU, Ugwu OP (2023) HIV resistance in patients with Sickle Cell Anaemia. Newport International Journal of Scientific and Experimental Sciences (NIJSES) 3(2): 56-59.
  60. Ifeanyi OE, Uzoma OG, Stella EI, Chinedum OK, Abum SC (2018) Vitamin D and insulin resistance in HIV sero positive individuals in Umudike. Int J Curr Res Med Sci 4(2): 104-108.
  61. Ifeanyi OE, Leticia OI, Nwosu D, Chinedum OK (2018) A Review on blood borne viral infections: universal precautions. Int J Adv Res Biol Sci 5(6): 60-66.
  62. Nwovu AI, Ifeanyi OE, Uzoma OG, Nwebonyi NS (2018) Occurrence of Some Blood Borne Viral Infection and Adherence to Universal Precautions among Laboratory Staff in Federal Teaching Hospital Abakaliki Ebonyi State. Arch Blood Transfus Disord 1(2).
  63. Obeagu EI, Obeagu GU, Ede MO, Odo EO, Buhari HA (2023) Translation of HIV/AIDS knowledge into behavior change among secondary school adolescents in Uganda: A review. Medicine (Baltimore) 102(49): e36599.
  64. Anyiam AF, Arinze AOC, Irondi EA, Obeagu EI (2023) Distribution of ABO and rhesus blood grouping with HIV infection among blood donors in Ekiti State Nigeria. Medicine (Baltimore) 102(47): e36342.
  65. Echefu SN, Udosen JE, Akwiwu EC, Akpotuzor JO, Obeagu EI (2023) Effect of Dolutegravir regimen against other regimens on some hematological parameters, CD4 count and viral load of people living with HIV infection in South Eastern Nigeria. Medicine (Baltimore) 102(47): e35910.
  66. Opeyemi AA, Obeagu EI (2023) Regulations of malaria in children with human immunodeficiency virus infection: A review. Medicine (Baltimore) 102(46): e36166.
  67. Alum EU, Obeagu EI, Ugwu OPC, Samson AO, Adepoju AO, et al. (2023) Inclusion of nutritional counseling and mental health services in HIV/AIDS management: A paradigm shift. Medicine (Baltimore) 102(41): e35673.
  68. Obeagu EI, Obeagu GU, Obiezu J, Ezeonwumelu C, Ogunnaya FU, et al. (2023) Hematologic Support in HIV Patients: Blood Transfusion Strategies and Immunological Considerations. Applied Sciences (NIJBAS) 3(3): 9-15.
  69. Obeagu EI, Ubosi NI, Uzoma G (2023) Storms and Struggles: Managing HIV Amid Natural Disasters. Int J Curr Res Chem Pharm Sci 10(11): 14-25.
  70. Tang L, Ding C, Li H, Zhou X, Yin G (2023) A Real- World Disproportionality Analysis of Drug-Induced Immune Hemolytic Anemia in the FDA Adverse Event Reporting System. Annals of Pharmacotherapy 10600280231189897.
  71. Obeagu EI, Obeagu GU (2023) Human Immunodeficiency Virus and tuberculosis infection: A review of prevalence of associated factors. Int J Adv Multidiscip Res 10(10): 56-62.
  72. Alum EU, Ugwu OP, Obeagu EI, Aja PM, Okon MB, et al. (2023) Reducing HIV Infection Rate in Women: A Catalyst to reducing HIV Infection pervasiveness in Africa. International Journal of Innovative and Applied Research 11(10): 1-6.
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@article{emmanuel2024,
  title   = {Antiretroviral Therapy and Red Blood Cell Morphology: A Review in HIV Patients},
  author  = {Emmanuel Ifeanyi Obeagu, Getrude Uzoma Obeagu and Matthew Chibunna Igwe},
  journal = {Haematology International Journal},
  year    = {2024},
  volume  = {8},
  number  = {1},
  doi     = {10.23880/hij-16000233}
}
Emmanuel Ifeanyi Obeagu, Getrude Uzoma Obeagu and Matthew Chibunna Igwe (2024). Antiretroviral Therapy and Red Blood Cell Morphology: A Review in HIV Patients. Haematology International Journal, 8(1). https://doi.org/10.23880/hij-16000233
TY  - JOUR
TI  - Antiretroviral Therapy and Red Blood Cell Morphology: A Review in HIV Patients
AU  - Emmanuel Ifeanyi Obeagu, Getrude Uzoma Obeagu and Matthew Chibunna Igwe
JO  - Haematology International Journal
PY  - 2024
VL  - 8
IS  - 1
DO  - 10.23880/hij-16000233
ER  -