Title : Mutual concomitance of pancytopenia and chronic heart failure in patients infected with human immunodeficiency virus
Abstract:
Human immunodeficiency virus (HIV) has direct and indirect effects on both bone marrow cells and cardiomyocytes. The common pathogenetic process unites the formation of pancytopenia and chronic heart failure (CHF) in HIV-infected patients. Pathogenesis of haematological disorders in HIV infection is a complex and multifactorial problem. It includes the following aspects: drug-induced disorders of haematopoiesis, bone marrow suppression as a result of infiltration by infectious agents or malignant by infectious agents or malignant cells, as well as HIV-induced changes in the process of haematopoiesis and a number of other factors. In a clinical study involving 240 patients with HIV-infection in the conditions of a multidisciplinary hospital, we have proved that there is a mutual conjugation of the processes of formation of CHF and pancytopenia in patients with HIV-infection. The chance of CVD development in patients with pancytopenia increases 12,3 times. In patients with pancytopenia on the background of Chronic Heart Failure with NT-proBNP level ≥300,4 pg/ml more often alcohol dependence and ventricular rhythm disturbances were detected more often. At the same time, NT proBNP level was much higher in pancytopenia, as well as the number of patients with severe CHF having NT-proBNP levels ≥ 1500 pg/ml, the latter suggesting that pancytopenia worsens the course of CHF. The concentration of the fibrosis marker TIMP-1 was higher in patients with pancytopenia, increasing simultaneously and equidirectionally with the level of NT-proBNP, which indicates activation of the process.
