Haematological Profiles of Newly Diagnosed HIV Patients Initiated on Dolutegravir-Based Therapy at the University of Nigeria Teaching Hospital, Enugu

Haematological Profiles of Newly Diagnosed HIV Patients Initiated on Dolutegravir-Based Therapy at the University of Nigeria Teaching Hospital, Enugu | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Haematological Profiles of Newly Diagnosed HIV Patients Initiated on Dolutegravir-Based Therapy at the University of Nigeria Teaching Hospital, Enugu ONWUKA KALU CHIMA OKPO, EJIKE FELIX CHUKWURAH This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6876600/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Dolutegravir (DTG), an integrase strand transfer inhibitor, is increasingly adopted as the preferred first-line antiretroviral therapy (ART) due to its potent virological efficacy and high barrier to resistance. However, emerging safety concerns—such as reports of neural tube defects, neuropsychiatric symptoms, and hematological abnormalities including sideroblastic anemia—have raised important questions regarding its long-term safety profile. Objective This study evaluated the impact of DTG-based ART on hematological parameters in HIV-positive treatment-naïve individuals. Methods A total of 40 treatment-naïve HIV-positive adults (19 males, 21 females) without co-morbidities were prospectively recruited from the Antiretroviral Therapy Clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu, between January 2023 and July 2024. Forty age- and sex-matched HIV-seronegative individuals served as controls. Baseline socio-demographic were collected using a structured questionnaire. Blood samples were obtained at baseline and after six months of DTG-based ART initiation. Complete blood count (CBC) was assessed using an automated hematology analyzer. Results Following six months of DTG-based ART, there was a statistically Significant hematological changes were also observed post-treatment, including increases in lymphocyte count (40.92 ± 12.79%), red blood cell count (4.28 ± 0.89 × 10¹²/L), hemoglobin (11.44 ± 2.61 g/dL), hematocrit (34.19 ± 7.55%), mean corpuscular volume (80.33 ± 6.95 fL), mean corpuscular hemoglobin (26.4 ± 3.03 pg), and neutrophil count (51.53 ± 2.41%). No significant changes were observed in mean corpuscular hemoglobin concentration (MCHC), red cell distribution width-coefficient of variation (RDW-CV), or red cell distribution width-standard deviation (RDW-SD). Conclusion DTG-based ART was associated with significant alterations in several hematological indices and anthropometric parameters after six months of therapy. These findings highlight the need for ongoing hematologic monitoring and long-term safety surveillance in patients receiving DTG-based regimens. Stem Cell & Developmental Cell Biology HAEMATOLOGY DOLUTEGRAVIR RED CELL INDICES PLATELET INDICES WHITE BLOOD CELLS COUNT Introduction Human Immunodeficiency Virus (HIV) infection remains a significant global health challenge, particularly in sub-Saharan Africa, which bears a disproportionate burden of the disease. The introduction and evolution of antiretroviral therapy (ART) have markedly improved clinical outcomes, reduced HIV-associated morbidity and mortality, and transformed HIV into a manageable chronic condition. Dolutegravir (DTG), a second-generation integrase strand transfer inhibitor (INSTI), has emerged as a preferred first-line ART component due to its high genetic barrier to resistance, once-daily dosing, and favorable virological efficacy. However, with the growing implementation of DTG-based regimens, concerns have been raised regarding its long-term safety, particularly in relation to potential hematological, metabolic, and neurodevelopmental complications. Weight loss and nutritional deficiencies—especially involving iron and folate—are common clinical manifestations of HIV infection, particularly in untreated individuals. These deficiencies, along with the virus’s direct impact on hematopoietic progenitor cells and bone marrow function, contribute to a spectrum of hematological abnormalities. Such abnormalities are among the most frequent and clinically significant complications observed in people living with HIV (PLWH), often serving as early indicators of disease progression and predictors of therapeutic challenges. In HIV/AIDS, there are biomarkers with both diagnostic and prognostic indicators relevant in the management. Since weight loss is associated with HIV, the assessment of folate, total iron and complete blood count (CBC) are therefore necessary in the management.Consequently, there is an increasing imperative to assess the clinical and biochemical impacts of this newer therapeutic regimen in order to guide evidence-based treatment protocols and enhance patient outcomes.This study, therefore, aims to investigate the effects of dolutegravir-based ART on anthropometric, hematological, in people living with HIV (PLWH), with the goal of better understanding the implications of this therapeutic shift within the local context.. Haematological parameters assess the health and functioning of blood components [Bain,2015].Hematological abnormalities are among the most frequent and clinically significant complications observed in individuals living with HIV, often serving as early markers of disease progression and therapeutic challenges. Anemia, leukopenia, and thrombocytopenia are particularly prevalent and contribute substantially to morbidity in this population. Anemia is the most common hematological manifestation and is strongly associated with advanced stages of HIV infection, poor nutritional status, chronic inflammation, and opportunistic infections. Its etiology is typically multifactorial, encompassing factors such as impaired bone marrow function, micronutrient deficiencies (notably iron and folate), and the suppressive effects of the virus on erythropoiesis.Leukopenia—especially lymphopenia and neutropenia—arises from both the direct cytopathic effects of HIV on hematopoietic progenitor cells and the broader immune dysregulation induced by chronic infection. This immune compromise increases susceptibility to recurrent bacterial, viral, and fungal infections. Thrombocytopenia, which may result from immune-mediated platelet destruction or secondary to ART and opportunistic infections, further complicates the clinical picture by heightening the risk of bleeding and impairing wound healing(Sloand,2005;Levine et al,2006).The progression of HIV disease causes these hematologic abnormalities to worsen and may adversely affect antiretroviral therapy (ART) outcomes, including treatment efficacy and patient adherence. Consequently, routine assessment of hematological parameters is vital for disease staging, early detection of complications, and monitoring of ART response—especially in resource-constrained settings where advanced diagnostics may be limited(Calis et al,2008;Volberding et al,2004). This study aims to evaluate the impact of dolutegravir-based ART on haematological indices in PLWH in Enugu, Nigeria. Materials and Methods Study Design and Participants This study was a cross-sectional, analytical investigation involving people living with HIV (PLWH) receiving medical care in Enugu, Nigeria. Participants included newly diagnosed HIV-positive individuals who had not initiated antiretroviral therapy and had no co-morbid conditions, as well as HIV-negative controls without significant health issues. Exclusion criteria comprised prior exposure to antiretroviral therapy, refusal to provide consent, or presence of known HIV-related co-morbidities. Ethical approval was obtained from the University of Nigeria Teaching Hospital Research Ethical Committee and written informed consent was secured from all participants prior to sample collection. Complete Blood Count (CBC) Analysis Complete blood count (CBC) parameters were determined using the Zybio Z31 Automated Hematology Analyzer , which operates on the Coulter principle. The analyzer quantifies cellular components by detecting changes in electrical resistance as cells suspended in an electrolyte solution pass through a narrow aperture. Each blood cell, when passing through the aperture, causes a momentary impedance (electrical resistance) change that is measured as an electrical pulse. The amplitude of this pulse is directly proportional to the cell's volume, allowing for differentiation and enumeration of red blood cells (RBCs), white blood cells (WBCs), and platelets (PLTs).For hemoglobin determination, the analyzer employs a colorimetric method. Upon addition of a lyse reagent, erythrocyte membranes are disrupted, releasing hemoglobin. The hemoglobin forms a chromogenic complex that is detected at a wavelength of 525 nm using an LED monochromatic light source. The transmitted light is measured by a photocell, and the resulting signal is amplified and analyzed against a baseline diluent reading to determine hemoglobin concentration. All measurements were performed according to the manufacturer’s instructions and in adherence to standard laboratory protocols (Coulter, 1953 ). Data Management and Statistical Analysis All data were coded and securely stored in a password-protected computer system. Each sample was assigned a unique laboratory identification number to ensure anonymity during processing and analysis. Personal identifiers such as names, contact details, and clinical histories were excluded from analytical datasets. Data analysis was conducted using the Statistical Package for Social Sciences (SPSS) version 26.0 for Windows. Descriptive statistics (means, standard deviations, frequencies, and percentages) were used to summarize continuous and categorical variables. Differences in continuous variables between groups were assessed using Student’s t -test, while the Chi-square test was employed for categorical data. A p-value of less than 0.05 was considered statistically significant. Results are presented using tables and graphical illustrations where appropriate. Confidentiality and Data Protection Participant confidentiality was strictly maintained throughout the study. All personal information, including age and contact details, was anonymized and securely stored. Laboratory results were identified solely by coded numbers and were communicated individually to each participant following analysis. Results Table 1:Demographic characteristics of the study population Subject n (%) Control n (%) 2 P value Age group 19 – 28 6 (16.2) 24 (64.9) 20.254 < 0.001 29 – 38 13 (35.1) 8 (21.6) 39 – 48 14 (37.8) 5 (13.5) 49 – 58 4 (10.8) 0 (0.0) Sex Male 18 (48.6) 19 (51.4) 0.054 0.816 Female 19 (51.4) 18 (48.6) Educational Status Primary 10 (27.0) 10 (27.0) 0.670 0.715 Secondary 16 (43.2) 13 (35.1) Tertiary 11 (29.7) 14 (37.8) Socioeconomic Status Low 27 (73.0) 26 (70.3) 1.019 0.601 Middle 10 (27.0) 10 (27.0) High 0 (0.0) 1 (2.7) Occupation Artisan 7 (18.9) 0 (0.0) 20.567 0.001 Business/trader 21 (56.8) 14 (37.8) Civil servant 7 (18.9) 17 (45.9) Farmer 0 (0.0) 3 (8.1) Student 0 (0.0) 3 (8.1) Unemployed 2 (5.4) 0 (0.0) Physical Health Status Asymptomatic 22 (59.5) 37 (100.0) 18.814 < 0.001 Symptomatic 15 (40.5) 0 (0.0) Marital Status Single 14 (37.8) 18 (48.6) 0.881 0.348 Married 23 (62.2) 19 (51.4) Table 1 shows that the age groups are significantly different between the subjects and controls ( 2 = 20.254, p < 0.001). The mean age is 37.32 ± 8.63, the minimum age is 19 while the maximum age is 53 years. There are 37.8% of the subjects aged between 39 – 48 years compared to 13.5% of controls within the age bracket. Conversely, there are 16.2% of the subjects aged between 19 – 28 years compared to 64.9% of controls within the age bracket. However, the gender proportions of both groups are not significantly different ( 2 = 0.054, p = 0.816). There are 48.6% and 51.4% male subjects and controls respectively. Majority of the subjects and controls have secondary education ( 2 = 0.670, p = 0.715), while more than 70% of participants in both groups are in the low socioeconomic class ( 2 = 1.019, p = 0.601). The subjects were predominantly business/traders (56.8%) compared to the controls that are predominantly civil servants (45.9%), ( 2 = 20.567, p = 0.001). Whereas all the controls are Asymptomatic, 40.5% of the subjects are symptomatic ( 2 = 18.814, p < 0.001). There are more married participants in both groups ( 2 = 0.881, p = 0.348). The comparison significance of the ART treatment naive and six months treatment experienced on Platelet indices based on 95% (p<0.05) Table 2: Paired Samples Test of Platelet indices Paired Samples Test Paired Differences T df Sig. (2-tailed) Mean Std. Deviation Std. Error Mean 95% Confidence Interval of the Difference Lower Upper PCT – PCT .01612 .07839 .01240 -.00895 .04120 1.301 39 .201 PDW PDW -.10750 .71482 .11302 -.33611 .12111 -.951 39 .347 MPV –MPV .34000 2.01173 .31808 -.30338 .98338 1.069 39 .292 PLT – PLT 31.050 174.471 27.586 -24.749 86.849 1.126 39 .267 None of the paired comparisons (PCT, PDW, MPV, and PLT) show statistically significant differences, as all p-values are greater than the threshold of 0.05. This implies that there is no evidence of significant changes in these parameters between the paired measurements. 🔬 Effects of Dolutegravir-Based Regimen on Haematological Parameters and Indices (Within-Subject Comparison) (Table 2: Paired Samples Test – Pre vs. Post Dolutegravir) Platelet Indices (PCT, PDW, MPV, PLT): None of the parameters showed a statistically significant change after Dolutegravir therapy. All p-values > 0.05 , indicating no meaningful within-subject difference due to the regimen. Dolutegravir-based ART does not significantly alter platelet indices in the short term. The comparative significance based on (p<0.05) between the dolutegravir -ART treatment naive, six months dolutegravir-ART treatment experienced participants and control(HIV- Negative) subjects. Table 3 Test Statistics a,b PCT PDW MPV PLT TWBC LYMPH NEUT MONO Kruskal-Wallis H 3.811 38.992 14.562 9.220 10.846 18.880 14.775 39.971 Df 2 2 2 2 2 2 2 2 Asymp. Sig. .149 .000 .001 .010 .004 .000 .001 .000 a. Kruskal Wallis Test b. Grouping Variable: ART-naïve subjects , ART-experienced subjects and control(HIV- Negative) subjects. Comparison Between Pre-DTG, Post-DTG, and HIV-Negative Controls (Table 3: Kruskal-Wallis Test for Platelet & White Blood Indices) No significant difference: PCT (p = 0.149). Significant differences (p < 0.05): PDW, MPV, PLT, TWBC, Lymphocytes, Neutrophils, and Monocytes. While PCT remains unaffected across groups, other indices (PDW, MPV, etc.) show notable group-dependent variations , indicating hematologic impact of HIV and/or ART status. Table 4 Test Statistics a,b RBC HB HCT MCV MCH MCHC RDW(CV) RDW(SD) Kruskal-Wallis H 37.902 48.946 53.441 27.263 24.123 48.855 18.820 65.249 Df 2 2 2 2 2 2 2 2 Asymp. Sig. .000 .000 .000 .000 .000 .000 .000 .000 a. Kruskal Wallis Test Red Blood Cell Parameters and Indices Across Groups (Table 4: Kruskal-Wallis Test for RBC Parameters) All parameters (RBC, HB, HCT, MCV, MCH, MCHC, RDW-CV, RDW-SD) showed statistically significant differences (all p = 0.000). Red blood cell parameters vary significantly between ART-naïve, ART-experienced, and HIV-negative individuals, highlighting the effects of both HIV infection and its treatment on erythropoiesis and red cell morphology. Table 5Paired differences for Total WBC, Differential WBC and RBC Paired Differences T Df Sig. (2-tailed) Mean Std. Deviation Std. Error Mean 95% Confidence Interval of the Difference Lower Upper TWBC -TWBC .74500 5.06348 .80061 -.87438 2.36438 .931 39 .358 LYMPHLYMPH -10.900 19.179 3.032 -17.034 -4.766 -3.594 39 .001 NEUT - NEUT 11.350 19.216 3.038 5.204 17.496 3.736 39 .001 MONO MONO -.256 2.531 .405 -1.077 .564 -.633 38 .531 RBC – RBC -.49225 1.31908 .20856 -.91411 -.07039 -2.360 39 .023 Statistically significant changes were observed in lymphocytes (increased, p = 0.001), neutrophils (decreased, p = 0.001), and RBC levels (increased, p = 0.023). No significant changes were observed in TWBC (p = 0.358) or monocytes (p = 0.531). This indicates specific shifts in certain haematological parameters between the paired measurements Table 6 Paired Samples Test Paired Differences t Df Sig. (2-tailed) Mean Std. Deviation Std. Error Mean 95% Confidence Interval of the Difference Lower Upper HB – HB -2.68750 3.15921 .49951 -3.69786 -1.67714 -5.380 39 .000 HCT – HCT -7.3450 8.7109 1.3773 -10.1309 -4.5591 -5.333 39 .000 MCV - MCV -7.7650 9.9212 1.5687 -10.9380 -4.5920 -4.950 39 .000 MCH - MCH -3.1575 4.3691 .6908 -4.5548 -1.7602 -4.571 39 .000 MCHC – MCHC -.53000 2.50140 .39551 -1.32999 .26999 -1.340 39 .188 RDW(CV)RDW(CV .53250 9.13930 1.44505 -2.39039 3.45539 .368 39 .714 RDW(SD)RDW(SD .85750 6.07048 .95983 -1.08393 2.79893 .893 39 .377 The Paired Samples Test for Haemoglobin(HB),Haematocrit(HCT) and Red cell indices(MCV,MCH,MCHC,RDW(CV),RDW(SD). Statistically significant increments were observed in HB (hemoglobin) , HCT (hematocrit) , MCH , MCV but no statistically significant changes were seen in MCHC, RDW(CV), RDW(SD) Discussion The findings of this study demonstrate notable effects of dolutegravir (DTG)-based antiretroviral therapy (ART) on the haematological indices of HIV-positive treatment-naïve and experienced individuals when compared with apparently healthy HIV-negative controls. These effects were observed across multiple haematological parameters, offering insight into the therapeutic and physiological impact of DTG-based regimens. A significant increase in lymphocyte count among treatment-experienced patients suggests an improvement in cellular immunity following ART initiation. This aligns with previous reports by Saha et al. ( 2015 ) in India and Mastroianni et al. ( 1999 ) in Rome, which observed enhanced immune cell profiles post-ART. The increase in lymphocytes may reflect immune reconstitution as a result of viral suppression and reduced HIV-related cytopathic effects. Conversely, some studies, including those by Talargia et al. ( 2021 ), Gudina et al. ( 2024 ), and Acharya et al. ( 2020 ), reported no significant change or even decreased lymphocyte counts, indicating that variability may arise from differences in study populations, ART regimens, or concurrent infections. A significant reduction in neutrophil and monocyte counts was observed among HIV-positive patients compared to controls. This trend, which differs from the comparable values reported by Echefu et al. ( 2023 ) and the increased counts noted by Gudina et al. ( 2024 ), may reflect the suppression of chronic immune activation following ART initiation or differing baseline levels due to opportunistic infections in the treatment-naïve group. The decline in neutrophil count, which typically responds to acute bacterial infections, may also indicate a reduced burden of opportunistic infections post-treatment initiation. Total white blood cell (WBC) count increased significantly in HIV-positive groups compared to HIV-negative controls, in agreement with findings from Damtie et al. ( 2021 ) in Ethiopia. However, this contrasts with studies by Echefu et al. ( 2023 ), Gudina et al. ( 2024 ), Princy et al. ( 2021 ), and Talargia et al. ( 2021 ), which reported either no significant change or a decrease. Differences in geographic location, baseline immune status, ART regimens, or co-infections may account for these discrepancies. Regarding red blood cell (RBC) indices, this study observed a significant post-ART increase in haemoglobin (Hb), haematocrit (HCT), RBC count, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), and red cell distribution width (RDW-CV and RDW-SD). These findings corroborate studies by Enawgaw et al. ( 2014 ), Rezaei et al. ( 2016 ), and Adediran et al. ( 2016 ), which demonstrated haematological recovery and improved erythropoiesis following effective ART. Choi et al. ( 2011 ) further supports this by explaining that DTG-based ART enhances erythropoietin (EPO) response, reduces haemolysis, and suppresses the release of immature red cells due to effective viral suppression. Nevertheless, contrasting results were reported by Damtie et al. ( 2021 ) and Rezaei et al. ( 2016 ), suggesting that haematological response may also depend on factors such as nutritional status, genetic predisposition, and ART adherence. Among platelet indices, Platelet Distribution Width (PDW) was significantly elevated in HIV-positive individuals compared to controls. This finding is indicative of increased platelet activation, which may have implications for cardiovascular and metabolic health. It aligns with the results reported by Gudina et al. ( 2024 ), highlighting a potential pro-inflammatory state despite ART. However, the mean platelet count was significantly decreased, which contradicts the findings of Echefu et al. ( 2023 ) and Gudina et al. ( 2024 ), who reported stable or increased platelet values following ART. Mean Platelet Volume (MPV) also decreased significantly, a result that is inconsistent with Gudina et al. ( 2024 ), who observed no significant change. These differences may arise from variations in disease stage, baseline haematological status, and ART regimen composition. The hypothesis testing revealed that while plateletcrit significantly differed among the groups (leading to rejection of the null hypothesis), other parameters such as platelet count, PDW, MPV, total WBC, lymphocyte count, neutrophil count, monocyte count, RBC count, Hb, HCT, and red cell indices did not yield statistically significant differences in certain pairwise comparisons, reinforcing the nuanced impact of DTG-based ART on specific haematological parameters. Overall, these findings underscore the multifaceted effects of DTG-based ART on haematological indices, supporting its role in immune restoration and haematological improvement in people living with HIV. However, inter-study variability highlights the need for further longitudinal and multi-centre studies to account for population-specific differences and long-term effects. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6876600","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":470136331,"identity":"b1ca84d6-c322-4760-a86e-cc6789a8eb56","order_by":0,"name":"ONWUKA KALU CHIMA OKPO","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+klEQVRIiWNgGAWjYJACxgaGBAY+BgY2IMUgBxI58IAYLWxQLcZgLQlEawGCxAYQiU8Lv3SPmeSMmjR5NonkZw8e5tilzw87/BBoi52cbgN2LZJzzphJbjiWY9gmkWZukLgtOXfj7TQDoJZkY7MD2LUY3MjdJvmArYKxTSKHTSJxG3PuxtkJIC0HErfh1fKvwh6qpT7dcHb6B8JaNrblJEK1HE6Ql87Bb4vkjPzPljP70pLbeJ6ZAbUcN9wgnVNwIMEAt1/4JdISb/Z8S7btZ09+JvlzW7W8/Oz0zR8+VNjJ4dKCxalglQbEKgcB+QZSVI+CUTAKRsFIAACK8WFtSvOkQQAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0009-0001-9882-5494","institution":"EBONYI STATE UNIVERSITY ABAKALIKI, EBONYI STATE","correspondingAuthor":true,"prefix":"","firstName":"ONWUKA","middleName":"KALU CHIMA","lastName":"OKPO","suffix":""},{"id":470136332,"identity":"f0117ccd-2171-40d0-8ceb-a00acc491d76","order_by":1,"name":"EJIKE FELIX CHUKWURAH","email":"","orcid":"","institution":"EBONYI STATE UNIVERSITY ,ABAKALIKI.EBONYI STATE","correspondingAuthor":false,"prefix":"","firstName":"EJIKE","middleName":"FELIX","lastName":"CHUKWURAH","suffix":""}],"badges":[],"createdAt":"2025-06-12 05:10:34","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-6876600/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6876600/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":84542691,"identity":"74299ad7-5ffa-40a0-a8f7-d61ad3e099ab","added_by":"auto","created_at":"2025-06-13 08:44:37","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1245386,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6876600/v1/73e13aa4-776d-4dff-842d-cf58d794daa2.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eHaematological Profiles of Newly Diagnosed HIV Patients Initiated on Dolutegravir-Based Therapy at the University of Nigeria Teaching Hospital, Enugu\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eHuman Immunodeficiency Virus (HIV) infection remains a significant global health challenge, particularly in sub-Saharan Africa, which bears a disproportionate burden of the disease. The introduction and evolution of antiretroviral therapy (ART) have markedly improved clinical outcomes, reduced HIV-associated morbidity and mortality, and transformed HIV into a manageable chronic condition. Dolutegravir (DTG), a second-generation integrase strand transfer inhibitor (INSTI), has emerged as a preferred first-line ART component due to its high genetic barrier to resistance, once-daily dosing, and favorable virological efficacy. However, with the growing implementation of DTG-based regimens, concerns have been raised regarding its long-term safety, particularly in relation to potential hematological, metabolic, and neurodevelopmental complications.\u003c/p\u003e \u003cp\u003eWeight loss and nutritional deficiencies\u0026mdash;especially involving iron and folate\u0026mdash;are common clinical manifestations of HIV infection, particularly in untreated individuals. These deficiencies, along with the virus\u0026rsquo;s direct impact on hematopoietic progenitor cells and bone marrow function, contribute to a spectrum of hematological abnormalities. Such abnormalities are among the most frequent and clinically significant complications observed in people living with HIV (PLWH), often serving as early indicators of disease progression and predictors of therapeutic challenges.\u003c/p\u003e \u003cp\u003eIn HIV/AIDS, there are biomarkers with both diagnostic and prognostic indicators relevant in the management. Since weight loss is associated with HIV, the assessment of folate, total iron and complete blood count (CBC) are therefore necessary in the management.Consequently, there is an increasing imperative to assess the clinical and biochemical impacts of this newer therapeutic regimen in order to guide evidence-based treatment protocols and enhance patient outcomes.This study, therefore, aims to investigate the effects of dolutegravir-based ART on anthropometric, hematological, in people living with HIV (PLWH), with the goal of better understanding the implications of this therapeutic shift within the local context.. Haematological parameters assess the health and functioning of blood components [Bain,2015].Hematological abnormalities are among the most frequent and clinically significant complications observed in individuals living with HIV, often serving as early markers of disease progression and therapeutic challenges. Anemia, leukopenia, and thrombocytopenia are particularly prevalent and contribute substantially to morbidity in this population. Anemia is the most common hematological manifestation and is strongly associated with advanced stages of HIV infection, poor nutritional status, chronic inflammation, and opportunistic infections. Its etiology is typically multifactorial, encompassing factors such as impaired bone marrow function, micronutrient deficiencies (notably iron and folate), and the suppressive effects of the virus on erythropoiesis.Leukopenia\u0026mdash;especially lymphopenia and neutropenia\u0026mdash;arises from both the direct cytopathic effects of HIV on hematopoietic progenitor cells and the broader immune dysregulation induced by chronic infection. This immune compromise increases susceptibility to recurrent bacterial, viral, and fungal infections. Thrombocytopenia, which may result from immune-mediated platelet destruction or secondary to ART and opportunistic infections, further complicates the clinical picture by heightening the risk of bleeding and impairing wound healing(Sloand,2005;Levine et al,2006).The progression of HIV disease causes these hematologic abnormalities to worsen and may adversely affect antiretroviral therapy (ART) outcomes, including treatment efficacy and patient adherence. Consequently, routine assessment of hematological parameters is vital for disease staging, early detection of complications, and monitoring of ART response\u0026mdash;especially in resource-constrained settings where advanced diagnostics may be limited(Calis et al,2008;Volberding et al,2004). This study aims to evaluate the impact of dolutegravir-based ART on haematological indices in PLWH in Enugu, Nigeria.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design and Participants\u003c/h2\u003e \u003cp\u003eThis study was a cross-sectional, analytical investigation involving people living with HIV (PLWH) receiving medical care in Enugu, Nigeria. Participants included newly diagnosed HIV-positive individuals who had not initiated antiretroviral therapy and had no co-morbid conditions, as well as HIV-negative controls without significant health issues. Exclusion criteria comprised prior exposure to antiretroviral therapy, refusal to provide consent, or presence of known HIV-related co-morbidities. Ethical approval was obtained from the University of Nigeria Teaching Hospital Research Ethical Committee and written informed consent was secured from all participants prior to sample collection.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eComplete Blood Count (CBC) Analysis\u003c/h3\u003e\n\u003cp\u003eComplete blood count (CBC) parameters were determined using the \u003cem\u003eZybio Z31 Automated Hematology Analyzer\u003c/em\u003e, which operates on the Coulter principle. The analyzer quantifies cellular components by detecting changes in electrical resistance as cells suspended in an electrolyte solution pass through a narrow aperture. Each blood cell, when passing through the aperture, causes a momentary impedance (electrical resistance) change that is measured as an electrical pulse. The amplitude of this pulse is directly proportional to the cell's volume, allowing for differentiation and enumeration of red blood cells (RBCs), white blood cells (WBCs), and platelets (PLTs).For hemoglobin determination, the analyzer employs a colorimetric method. Upon addition of a lyse reagent, erythrocyte membranes are disrupted, releasing hemoglobin. The hemoglobin forms a chromogenic complex that is detected at a wavelength of 525 nm using an LED monochromatic light source. The transmitted light is measured by a photocell, and the resulting signal is amplified and analyzed against a baseline diluent reading to determine hemoglobin concentration. All measurements were performed according to the manufacturer\u0026rsquo;s instructions and in adherence to standard laboratory protocols (Coulter, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e1953\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eData Management and Statistical Analysis\u003c/h3\u003e\n\u003cp\u003eAll data were coded and securely stored in a password-protected computer system. Each sample was assigned a unique laboratory identification number to ensure anonymity during processing and analysis. Personal identifiers such as names, contact details, and clinical histories were excluded from analytical datasets.\u003c/p\u003e \u003cp\u003eData analysis was conducted using the Statistical Package for Social Sciences (SPSS) version 26.0 for Windows. Descriptive statistics (means, standard deviations, frequencies, and percentages) were used to summarize continuous and categorical variables. Differences in continuous variables between groups were assessed using Student\u0026rsquo;s \u003cem\u003et\u003c/em\u003e-test, while the Chi-square test was employed for categorical data. A p-value of less than 0.05 was considered statistically significant. Results are presented using tables and graphical illustrations where appropriate.\u003c/p\u003e\n\u003ch3\u003eConfidentiality and Data Protection\u003c/h3\u003e\n\u003cp\u003eParticipant confidentiality was strictly maintained throughout the study. All personal information, including age and contact details, was anonymized and securely stored. Laboratory results were identified solely by coded numbers and were communicated individually to each participant following analysis.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eTable \u0026nbsp;1:Demographic characteristics of the study population\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003eSubject\u003c/p\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003eP value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eAge group\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e19 \u0026ndash; 28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e6 (16.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e24 (64.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e20.254\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e29 \u0026ndash; 38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e13 (35.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e8 (21.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e\u0026nbsp;39 \u0026ndash; 48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e14 (37.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e5 (13.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e49 \u0026ndash; 58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e4 (10.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eSex\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e18 (48.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e19 (51.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e0.054\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e0.816\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e19 (51.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e18 (48.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eEducational Status\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e10 (27.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e10 (27.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e0.670\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e0.715\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e16 (43.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e13 (35.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eTertiary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e11 (29.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e14 (37.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eSocioeconomic Status\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e27 (73.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e26 (70.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1.019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e0.601\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eMiddle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e10 (27.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e10 (27.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e1 (2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eOccupation\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eArtisan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e7 (18.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e20.567\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eBusiness/trader\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e21 (56.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e14 (37.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eCivil servant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e7 (18.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e17 (45.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eFarmer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e3 (8.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eStudent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e3 (8.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e2 (5.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ePhysical Health Status\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eAsymptomatic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e22 (59.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e37 (100.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e18.814\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eSymptomatic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e15 (40.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eMarital Status\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e14 (37.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e18 (48.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e0.881\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e0.348\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 114px;\"\u003e\n \u003cp\u003e23 (62.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e19 (51.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 1 shows that the age groups are significantly different between the subjects and controls ( \u003csup\u003e2\u0026nbsp;\u003c/sup\u003e= 20.254, p \u0026lt; 0.001). The mean age is 37.32 \u0026plusmn; 8.63, the minimum age is 19 while the maximum age is 53 years. There are 37.8% of the subjects aged between 39 \u0026ndash; 48 years compared to 13.5% of controls within the age bracket. Conversely, there are 16.2% of the subjects aged between 19 \u0026ndash; 28 years compared to 64.9% of controls within the age bracket. However, the gender proportions of both groups are not significantly different ( \u003csup\u003e2\u0026nbsp;\u003c/sup\u003e= 0.054, p = 0.816). There are 48.6% and 51.4% male subjects and controls respectively. Majority of the subjects and controls have secondary education ( \u003csup\u003e2\u0026nbsp;\u003c/sup\u003e= 0.670, p = 0.715), while more than 70% of participants in both groups are in the low socioeconomic class ( \u003csup\u003e2\u0026nbsp;\u003c/sup\u003e= 1.019, p = 0.601). The subjects were predominantly business/traders (56.8%) compared to the controls that are predominantly civil servants (45.9%), ( \u003csup\u003e2\u0026nbsp;\u003c/sup\u003e= 20.567, p = 0.001). Whereas all the controls are Asymptomatic, 40.5% of the subjects are symptomatic ( \u003csup\u003e2\u0026nbsp;\u003c/sup\u003e= 18.814, p \u0026lt; 0.001). There are more married participants in both groups ( \u003csup\u003e2\u0026nbsp;\u003c/sup\u003e= 0.881, p = 0.348).\u003c/p\u003e\n\u003cp\u003eThe comparison significance of the ART treatment naive and six months treatment experienced on Platelet indices based on 95% (p\u0026lt;0.05)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2: Paired Samples Test of Platelet indices \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"710\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"10\" style=\"width: 710px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePaired Samples Test\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 119px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"bottom\" style=\"width: 383px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePaired Differences\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003eT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003edf\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003eSig. (2-tailed)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003eStd. Deviation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003eStd. Error Mean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 155px;\"\u003e\n \u003cp\u003e95% Confidence Interval of the Difference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 77px;\"\u003e\n \u003cp\u003eLower\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 78px;\"\u003e\n \u003cp\u003eUpper\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003ePCT \u0026ndash; PCT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e.01612\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e.07839\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e.01240\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e-.00895\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e.04120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e1.301\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e.201\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003ePDW PDW\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e-.10750\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e.71482\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e.11302\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e-.33611\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e.12111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e-.951\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e.347\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003eMPV \u0026ndash;MPV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e.34000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e2.01173\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e.31808\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e-.30338\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e.98338\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e1.069\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e.292\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 119px;\"\u003e\n \u003cp\u003ePLT \u0026ndash; PLT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e31.050\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e174.471\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e27.586\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e-24.749\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e86.849\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e1.126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e.267\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNone of the paired comparisons (PCT, PDW, MPV, and PLT) show statistically significant differences, as all p-values are greater than the threshold of 0.05. This implies that there is no evidence of significant changes in these parameters between the paired measurements.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e🔬\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Effects of Dolutegravir-Based Regimen on Haematological Parameters and Indices (Within-Subject Comparison)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e(Table 2: Paired Samples Test \u0026ndash; Pre vs. Post Dolutegravir)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePlatelet Indices (PCT, PDW, MPV, PLT):\u003c/strong\u003e\u003c/p\u003e\n\u003cul type=\"disc\"\u003e\n \u003cli\u003eNone of the parameters showed a \u003cstrong\u003estatistically significant change\u003c/strong\u003e after Dolutegravir therapy.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eAll p-values \u0026gt; 0.05\u003c/strong\u003e, indicating \u003cstrong\u003eno meaningful within-subject difference\u003c/strong\u003e due to the regimen.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u0026nbsp;Dolutegravir-based ART does \u003cstrong\u003enot significantly alter\u003c/strong\u003e platelet indices in the short term.\u003c/p\u003e\n\u003cp\u003eThe comparative significance based on (p\u0026lt;0.05) between the dolutegravir -ART treatment naive, six months dolutegravir-ART treatment experienced participants \u0026nbsp;and control(HIV- Negative) subjects.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"671\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" style=\"width: 671px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 3\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eTest Statistics\u003csup\u003ea,b\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 115px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003ePCT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003ePDW\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003eMPV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003ePLT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003eTWBC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003eLYMPH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003eNEUT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 69px;\"\u003e\n \u003cp\u003eMONO\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003eKruskal-Wallis H\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e3.811\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e38.992\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e14.562\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e9.220\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e10.846\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e18.880\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e14.775\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e39.971\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003eDf\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003eAsymp. Sig.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e.149\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e.010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 671px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003ea. Kruskal Wallis Test\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 671px;\"\u003e\n \u003cp\u003eb. Grouping Variable: ART-na\u0026iuml;ve subjects , ART-experienced subjects and control(HIV- Negative)\u0026nbsp;subjects.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eComparison Between Pre-DTG, Post-DTG, and HIV-Negative Controls\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(Table 3: Kruskal-Wallis Test for Platelet \u0026amp; White Blood Indices)\u003c/strong\u003e\u003c/p\u003e\n \u003cul type=\"disc\"\u003e\n \u003cli\u003e\u003cstrong\u003eNo significant difference:\u003c/strong\u003e PCT (p = 0.149).\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eSignificant differences (p \u0026lt; 0.05):\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;PDW, MPV, PLT, TWBC, Lymphocytes, Neutrophils, and Monocytes.\u003c/li\u003e\n \u003c/ul\u003e\n \u003cp\u003eWhile PCT remains unaffected across groups, other indices (PDW, MPV, etc.) show \u003cstrong\u003enotable group-dependent variations\u003c/strong\u003e, indicating hematologic impact of HIV and/or ART status.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4 \u003cstrong\u003eTest Statistics\u003csup\u003ea,b\u003c/sup\u003e\u003c/strong\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"696\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 64px;\"\u003e\n \u003cp\u003eRBC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003eHB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 72px;\"\u003e\n \u003cp\u003eHCT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 60px;\"\u003e\n \u003cp\u003eMCV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 66px;\"\u003e\n \u003cp\u003eMCH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 78px;\"\u003e\n \u003cp\u003eMCHC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003eRDW(CV)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 87px;\"\u003e\n \u003cp\u003eRDW(SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eKruskal-Wallis H\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e37.902\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e48.946\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e53.441\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e27.263\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e24.123\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e48.855\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e18.820\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e65.249\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eDf\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003eAsymp. Sig.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 64px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 696px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ea. Kruskal Wallis Test\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 696px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRed Blood Cell Parameters and Indices Across Groups\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(Table 4: Kruskal-Wallis Test for RBC Parameters)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eAll parameters (RBC, HB, HCT, MCV, MCH, MCHC, RDW-CV, RDW-SD) showed \u003cstrong\u003estatistically significant differences\u003c/strong\u003e (all p = 0.000).\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;Red blood cell parameters vary \u003cstrong\u003esignificantly\u003c/strong\u003e between ART-na\u0026iuml;ve, ART-experienced, and HIV-negative individuals, highlighting the effects of both HIV infection and its treatment on erythropoiesis and red cell morphology.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5Paired differences for Total WBC, Differential WBC and RBC\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"715\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"3\" valign=\"bottom\" style=\"width: 144px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"bottom\" style=\"width: 387px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePaired Differences\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDf\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 75px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSig. (2-tailed)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStd. Deviation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStd. Error Mean\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% Confidence Interval of the Difference\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLower\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUpper\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003eTWBC -TWBC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e.74500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e5.06348\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e.80061\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e-.87438\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e2.36438\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e.931\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e.358\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003eLYMPHLYMPH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e-10.900\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e19.179\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e3.032\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e-17.034\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e-4.766\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e-3.594\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003eNEUT - NEUT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e11.350\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e19.216\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e3.038\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e5.204\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e17.496\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e3.736\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003eMONO MONO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e-.256\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e2.531\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e.405\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e-1.077\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e.564\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e-.633\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e.531\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 77px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003eRBC \u0026ndash; RBC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e-.49225\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1.31908\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e.20856\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e-.91411\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e-.07039\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e-2.360\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e.023\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eStatistically significant changes were observed in lymphocytes (increased, p = 0.001), neutrophils (decreased, p = 0.001), and RBC levels (increased, p = 0.023).\u003c/p\u003e\n\u003cp\u003eNo significant changes were observed in TWBC (p = 0.358) or monocytes (p = 0.531).\u003cbr\u003e\u0026nbsp;This indicates specific shifts in certain haematological parameters between the paired measurements\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 6\u0026nbsp;\u003cstrong\u003ePaired Samples Test\u003c/strong\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"682\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"3\" valign=\"bottom\" style=\"width: 148px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"bottom\" style=\"width: 355px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePaired Differences\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003et\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDf\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"bottom\" style=\"width: 73px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSig. (2-tailed)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStd. Deviation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStd. Error Mean\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% Confidence Interval of the Difference\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLower\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUpper\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eHB \u0026ndash; HB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e-2.68750\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e3.15921\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e.49951\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e-3.69786\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e-1.67714\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e-5.380\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eHCT \u0026ndash; HCT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e-7.3450\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e8.7109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1.3773\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e-10.1309\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e-4.5591\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e-5.333\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eMCV - MCV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e-7.7650\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e9.9212\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1.5687\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e-10.9380\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e-4.5920\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e-4.950\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eMCH - MCH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e-3.1575\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e4.3691\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e.6908\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e-4.5548\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e-1.7602\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e-4.571\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eMCHC \u0026ndash; MCHC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e-.53000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e2.50140\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e.39551\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e-1.32999\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e.26999\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e-1.340\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e.188\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eRDW(CV)RDW(CV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e.53250\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e9.13930\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e1.44505\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e-2.39039\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e3.45539\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e.368\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e.714\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 40px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eRDW(SD)RDW(SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e.85750\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e6.07048\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e.95983\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e-1.08393\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 76px;\"\u003e\n \u003cp\u003e2.79893\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e.893\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 53px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003e.377\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eThe Paired Samples Test for Haemoglobin(HB),Haematocrit(HCT) and Red cell indices(MCV,MCH,MCHC,RDW(CV),RDW(SD).\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStatistically significant increments were observed in \u003cstrong\u003eHB (hemoglobin)\u003c/strong\u003e, \u003cstrong\u003eHCT (hematocrit)\u003c/strong\u003e, \u003cstrong\u003eMCH\u003c/strong\u003e,\u003cstrong\u003e\u0026nbsp;MCV\u0026nbsp;\u003c/strong\u003ebut no statistically significant changes were seen in\u003cstrong\u003e\u0026nbsp;MCHC, RDW(CV), RDW(SD)\u003c/strong\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe findings of this study demonstrate notable effects of dolutegravir (DTG)-based antiretroviral therapy (ART) on the haematological indices of HIV-positive treatment-na\u0026iuml;ve and experienced individuals when compared with apparently healthy HIV-negative controls. These effects were observed across multiple haematological parameters, offering insight into the therapeutic and physiological impact of DTG-based regimens.\u003c/p\u003e \u003cp\u003eA significant increase in lymphocyte count among treatment-experienced patients suggests an improvement in cellular immunity following ART initiation. This aligns with previous reports by Saha et al. (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2015\u003c/span\u003e) in India and Mastroianni et al. (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e1999\u003c/span\u003e) in Rome, which observed enhanced immune cell profiles post-ART. The increase in lymphocytes may reflect immune reconstitution as a result of viral suppression and reduced HIV-related cytopathic effects. Conversely, some studies, including those by Talargia et al. (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), Gudina et al. (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2024\u003c/span\u003e), and Acharya et al. (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2020\u003c/span\u003e), reported no significant change or even decreased lymphocyte counts, indicating that variability may arise from differences in study populations, ART regimens, or concurrent infections.\u003c/p\u003e \u003cp\u003eA significant reduction in neutrophil and monocyte counts was observed among HIV-positive patients compared to controls. This trend, which differs from the comparable values reported by Echefu et al. (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) and the increased counts noted by Gudina et al. (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2024\u003c/span\u003e), may reflect the suppression of chronic immune activation following ART initiation or differing baseline levels due to opportunistic infections in the treatment-na\u0026iuml;ve group. The decline in neutrophil count, which typically responds to acute bacterial infections, may also indicate a reduced burden of opportunistic infections post-treatment initiation.\u003c/p\u003e \u003cp\u003eTotal white blood cell (WBC) count increased significantly in HIV-positive groups compared to HIV-negative controls, in agreement with findings from Damtie et al. (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) in Ethiopia. However, this contrasts with studies by Echefu et al. (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2023\u003c/span\u003e), Gudina et al. (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2024\u003c/span\u003e), Princy et al. (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), and Talargia et al. (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), which reported either no significant change or a decrease. Differences in geographic location, baseline immune status, ART regimens, or co-infections may account for these discrepancies.\u003c/p\u003e \u003cp\u003eRegarding red blood cell (RBC) indices, this study observed a significant post-ART increase in haemoglobin (Hb), haematocrit (HCT), RBC count, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), and red cell distribution width (RDW-CV and RDW-SD). These findings corroborate studies by Enawgaw et al. (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2014\u003c/span\u003e), Rezaei et al. (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2016\u003c/span\u003e), and Adediran et al. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2016\u003c/span\u003e), which demonstrated haematological recovery and improved erythropoiesis following effective ART. Choi et al. (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2011\u003c/span\u003e) further supports this by explaining that DTG-based ART enhances erythropoietin (EPO) response, reduces haemolysis, and suppresses the release of immature red cells due to effective viral suppression. Nevertheless, contrasting results were reported by Damtie et al. (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) and Rezaei et al. (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2016\u003c/span\u003e), suggesting that haematological response may also depend on factors such as nutritional status, genetic predisposition, and ART adherence.\u003c/p\u003e \u003cp\u003eAmong platelet indices, Platelet Distribution Width (PDW) was significantly elevated in HIV-positive individuals compared to controls. This finding is indicative of increased platelet activation, which may have implications for cardiovascular and metabolic health. It aligns with the results reported by Gudina et al. (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2024\u003c/span\u003e), highlighting a potential pro-inflammatory state despite ART. However, the mean platelet count was significantly decreased, which contradicts the findings of Echefu et al. (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) and Gudina et al. (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2024\u003c/span\u003e), who reported stable or increased platelet values following ART. Mean Platelet Volume (MPV) also decreased significantly, a result that is inconsistent with Gudina et al. (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2024\u003c/span\u003e), who observed no significant change. These differences may arise from variations in disease stage, baseline haematological status, and ART regimen composition.\u003c/p\u003e \u003cp\u003eThe hypothesis testing revealed that while plateletcrit significantly differed among the groups (leading to rejection of the null hypothesis), other parameters such as platelet count, PDW, MPV, total WBC, lymphocyte count, neutrophil count, monocyte count, RBC count, Hb, HCT, and red cell indices did not yield statistically significant differences in certain pairwise comparisons, reinforcing the nuanced impact of DTG-based ART on specific haematological parameters.\u003c/p\u003e \u003cp\u003eOverall, these findings underscore the multifaceted effects of DTG-based ART on haematological indices, supporting its role in immune restoration and haematological improvement in people living with HIV. However, inter-study variability highlights the need for further longitudinal and multi-centre studies to account for population-specific differences and long-term effects.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAcharya N, Madi A, Zhang H, Klapholz M, Escobar G, Dulberg S, Christian E, Ferreira M, Dixon KO, Fell G, Tooley K, Mangani D, Xia J, Singer M, Bosenberg M, Neuberg D, Rozenblatt-Rosen O, Regev A, Kuchroo VK, Anderson AC (2020) Endogenous Glucocorticoid Signaling Regulates CD8\u003csup\u003e+\u003c/sup\u003e T Cell Differentiation and Development of Dysfunction in the Tumor Microenvironment. Immunity 53(3):658\u0026ndash;671e6\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAdediran A, Osunkalu V, Wakama T, John-Olabode S, Akinbami A, Uche E, Akanmu S (2016) Impact of HIV Infection and Zidovudine Therapy on RBC Parameters and Urine Methylmalonic Acid Levels. \u003cem\u003eInterdisciplinary perspectives on infectious diseases\u003c/em\u003e, \u003cem\u003e2016\u003c/em\u003e, 5210963\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBain BJ \u003cem\u003eBlood Cells: A Practical Guide(2015)\u003c/em\u003e. Wiley-Blackwell\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCalis JC, Phiri KS, Faragher EB, Brabin BJ, Bates I, Cuevas LE, de Haan RJ, Phiri AI, Malange P, Khoka M, Hulshof PJ, van Lieshout L, Beld MG, Teo YY, Rockett KA, Richardson A, Kwiatkowski DP, Molyneux ME, van Hensbroek MB (2008) Severe anemia in Malawian children. 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HIV/AIDS (Auckland N Z) 13:477\u0026ndash;484\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEchefu 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 102(47):e35910\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEnawgaw B, Alem M, Addis Z, Melku M (2014) Determination of hematological and immunological parameters among HIV positive patients taking highly active antiretroviral treatment and treatment na\u0026iuml;ve in the antiretroviral therapy clinic of Gondar University Hospital, Gondar, Northwest Ethiopia: A com. BMC Hematol 14(1):8\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGudina A, Wordofa M, Urgessa F (2024) Immuno-hematological parameters among adult HIV patients before and after initiation of Dolutegravir based antiretroviral therapy, Addis Ababa, Ethiopia. PLoS ONE, 19(10), e0310239\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLevine AM, Karim R, Mack W, Gravink DJ, Anastos K, Young M, Cohen M, Newman M, Augenbraun M, Gange S, Watts DH (2006) Neutropenia in human immunodeficiency virus infection: data from the women's interagency HIV study. Arch Intern Med 166(4):405\u0026ndash;410\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMastroianni CM, Lichtner M, Mengoni F, D'Agostino C, Forcina G, d\u0026rsquo;Ettorre G, Santopadre P, Vullo V (1999) Improvement in neutrophil and monocyte function during highly active antiretroviral treatment of HIV-1-infected patients. \u003cem\u003eAIDS, 13 8\u003c/em\u003e, 883\u0026thinsp;\u0026ndash;\u0026thinsp;90\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePrincy JJ, Singh K, Biplab N, Reema N, Boini R, Gowde A (2021) Hematological Profile of HIV-Infected Patients on First-Line Highly Active Antiretroviral Therapy and Its Correlation With CD4 Count. 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J Blood Med 12:269\u0026ndash;276\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Ebonyi State University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"HAEMATOLOGY, DOLUTEGRAVIR, RED CELL INDICES, PLATELET INDICES, WHITE BLOOD CELLS COUNT","lastPublishedDoi":"10.21203/rs.3.rs-6876600/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6876600/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eDolutegravir (DTG), an integrase strand transfer inhibitor, is increasingly adopted as the preferred first-line antiretroviral therapy (ART) due to its potent virological efficacy and high barrier to resistance. However, emerging safety concerns\u0026mdash;such as reports of neural tube defects, neuropsychiatric symptoms, and hematological abnormalities including sideroblastic anemia\u0026mdash;have raised important questions regarding its long-term safety profile.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eThis study evaluated the impact of DTG-based ART on hematological parameters in HIV-positive treatment-na\u0026iuml;ve individuals.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA total of 40 treatment-na\u0026iuml;ve HIV-positive adults (19 males, 21 females) without co-morbidities were prospectively recruited from the Antiretroviral Therapy Clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu, between January 2023 and July 2024. Forty age- and sex-matched HIV-seronegative individuals served as controls. Baseline socio-demographic were collected using a structured questionnaire. Blood samples were obtained at baseline and after six months of DTG-based ART initiation. Complete blood count (CBC) was assessed using an automated hematology analyzer.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eFollowing six months of DTG-based ART, there was a statistically Significant hematological changes were also observed post-treatment, including increases in lymphocyte count (40.92\u0026thinsp;\u0026plusmn;\u0026thinsp;12.79%), red blood cell count (4.28\u0026thinsp;\u0026plusmn;\u0026thinsp;0.89 \u0026times; 10\u0026sup1;\u0026sup2;/L), hemoglobin (11.44\u0026thinsp;\u0026plusmn;\u0026thinsp;2.61 g/dL), hematocrit (34.19\u0026thinsp;\u0026plusmn;\u0026thinsp;7.55%), mean corpuscular volume (80.33\u0026thinsp;\u0026plusmn;\u0026thinsp;6.95 fL), mean corpuscular hemoglobin (26.4\u0026thinsp;\u0026plusmn;\u0026thinsp;3.03 pg), and neutrophil count (51.53\u0026thinsp;\u0026plusmn;\u0026thinsp;2.41%). No significant changes were observed in mean corpuscular hemoglobin concentration (MCHC), red cell distribution width-coefficient of variation (RDW-CV), or red cell distribution width-standard deviation (RDW-SD).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eDTG-based ART was associated with significant alterations in several hematological indices and anthropometric parameters after six months of therapy. These findings highlight the need for ongoing hematologic monitoring and long-term safety surveillance in patients receiving DTG-based regimens.\u003c/p\u003e","manuscriptTitle":"Haematological Profiles of Newly Diagnosed HIV Patients Initiated on Dolutegravir-Based Therapy at the University of Nigeria Teaching Hospital, Enugu","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-13 08:28:32","doi":"10.21203/rs.3.rs-6876600/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6df662a8-c374-4028-ae17-8c26aca92472","owner":[],"postedDate":"June 13th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":49921031,"name":"Stem Cell \u0026 Developmental Cell Biology"}],"tags":[],"updatedAt":"2025-06-13T08:28:32+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-13 08:28:32","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6876600","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6876600","identity":"rs-6876600","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}