Study of Bone Marrow Findings in Human Immunodeficiency Virus (HIV)Positive Patients in a Tertiary Care Hospital

Introduction: Human immunodeficiency virus (HIV) has emerged as a cause of morbidity and mortality worldwide. HIV positive patients commonly suffer from various hematological abnormalities of all lineages, which are diverse and can occur at any stage of infection. Hematologists should be aware of bone marrow changes associated with retroviral disease (RVD) so that appropriate and prompt treatment can be given to these patients. Methods: The study was carried out in the department of clinical pathology of a tertiary care hospital for the duration of 1 year, from January 2023 to December 2023. Out of a total of 90 bone marrow received, 20 patients were retrospectively studied for morphological changes in bone marrow who were HIV positive on ELISA and confirmed on Western blot. Results: The age range of the study population was 22 to 60 years. There was a predominance of male participants (85%). The predominant hematological abnormality on peripheral smear was anemia (90%). Microcytic hypochromic type of anemia was the most frequently observed finding. The bone marrow was hypercellular (70%) in most cases. Erythroid hyperplasia was seen in 14 cases. Erythroid normoblastic maturation was predominant (70%). Dysplasia was noted in 12 cases out of 20 cases, with isolated erythroid dysplasia (25%) being the most common. Reactive changes associated with HIV were also observed. In addition, we also reported one case of autoimmune hemolytic anemia and another of visceral leishmaniasis, both associated with HIV infection. Conclusion: A bone marrow study, along with a detailed approach to all relevant possible contributors and clinical history, should be considered for the diagnostic approach in documenting peripheral hematological abnormalities, opportunistic infections, and malignancies in HIV positive patients. .