Platelet activities in pregnant women living with Human Immunodeficiency Virus on HAART in Lagos , Nigeria.

Abstract

Introduction:Thrombocytopenia due to insufficient thromboxane A₂ activation has been an independent predictor associated with bleeding in some pregnant women living with HIV. More so, the elevation in the systemic vasoconstriction by the abnormal activation of platelets through thromboxane A₂ is a multi-system disorder during pregnancy resulting in maternal hypertension which is one of the major underlying pathophysiological occurrences in women with preeclampsia.

Materials and Method: A cross-sectional, descriptive study to determine platelet activities in pregnant women living with Human Immunodeficiency Virus on HAART residing in Lagos State, was carried out. A total of 80 samples were collected; 40 from pregnant women on HAART (group A), 20 samples from HIV negative pregnant women (group B) and 20 from non-pregnant HIV positive women on HAART (group C). The samples were analyzed using automated haematology analyzer (MIDRAY BC 10), platelets morphology was reviewed from blood films stained by Leishman stain and thromboxane A₂ was quantified using standard ELISA technique. Data was analyzed with SPSS version 23.0. Values were considered significantly different at P < 0.05.

Results:The platelets count results revealed the mean ± standard error of mean (SEM) in group A, group B and group C as 236.27 ± 11.40, 227.26 ± 16.44 and 246.21 ± 21.54 respectively ( p = 0.743). The Platelet distribution width (PDW) revealed the mean ± SEM in group A, group B and group C as 13.50 ± 0.42 ,13.36 ± 0.53 and 12.56 ± 0.52 ( p = 0.390 ) . As for mean platelet volume (MPV), the mean ± SEM for group A, group B and group C were 12.36 ± 1.96, 10.71 ± 0.37, and 10.45 ± 1.78 respectively(p = 0.671). The mean ± SEM of thromboxane A₂ in group A, group B and group C were 367.65 ± 37.74, 135.85 ± 51.69 and 276.10 ± 50.90 (p = 0.02).

Conclusion and Recommendation: This study showed platelet aggregation in group A, group B and group C were 7.5% , 0%, and 2%; and this could be  one of the suggestive factors in the increase in coagulation activities found in pregnancy. Thromboxane A₂ level reflects a recent activation of platelets, thus it serves as a good biomarker. It is recommended that research be conducted to establish reference ranges of Thromboxane A₂ for categories of normal individuals, including pregnant women in Lagos while attention should be paid to platelet activity studies in the Prevention of Mother to Child Transmission (PMTCT) programmes, to prevent mortality of participants on account of platelet aberrations.