THE IMPACT OF PANCYTOPENIA ON THE MANIFESTATIONS OF CHRONIC HEART FAILURE IN PATIENTS INFECTED WITH THE HUMAN IMMUNODEFICIENCY VIRUS: A CROSS-SECTIONAL STUDY

Abstract

Background: Human immunodeficiency virus (HIV) infection affects not only immune function but also bone marrow hematopoiesis, resulting in hematological abnormalities including anemia, thrombocytopenia, neutropenia, and pancytopenia. Chronic heart failure (CHF) also occurs more frequently, at a younger age, and with more rapid progression among people living with HIV than in individuals without HIV infection. However, the relationship between pancytopenia and the clinical severity of CHF in HIV-infected patients remains insufficiently characterized.

Objective: To assess the association between pancytopenia and the clinical, instrumental, and laboratory manifestations of chronic heart failure among patients infected with HIV.

Methods: This cross-sectional study included 240 patients with HIV infection, of whom 160 had CHF. Among patients with CHF, 63 had pancytopenia. The influence of pancytopenia on CHF manifestations was evaluated by comparing clinical, anamnestic, instrumental, and laboratory parameters between HIV-infected patients with CHF with and without pancytopenia.

Results: HIV-infected patients with CHF and concomitant pancytopenia demonstrated more severe heart failure, reflected by a higher functional class and more pronounced clinical manifestations. Pancytopenia was also associated with greater diastolic myocardial dysfunction and higher indices of aortic stiffness. Patients with pancytopenia had higher levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and tissue inhibitor of metalloproteinase-1 (TIMP-1), together with lower CD4+ T-lymphocyte counts, compared with patients without pancytopenia.

Conclusion: Pancytopenia is associated with more severe clinical and structural-functional manifestations of chronic heart failure in people living with HIV. The coexistence of pancytopenia and CHF may reflect interconnected pathogenic processes involving HIV-associated immune dysfunction, impaired hematopoiesis, myocardial remodeling, and vascular stiffness.

                     

Peer Review History:

Received 3 June 2026;   Reviewed 7 July 2026; Accepted  9 August; Available online 15 September 2026

Academic Editor: Dr. Emmanuel O. Olorunsola, Department of Pharmaceutics & Pharmaceutical Technology, University of Uyo, Nigeria, [email protected]

Reviewers:

Dr. Rawaa Souhil Al-Kayali, Aleppo University, Syria, [email protected]

Dr. Rana Ahmed MohamedEl-Saied El-Fitiany, Ahram Canadian University, Giza, Egypt, [email protected]