Changes in Platelet and CD4 Lymphocyte Counts After Antiretroviral Therapy in HIV-Infected Children

Vollständiger Abstract

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Human immunodeficiency virus (HIV) infection in children causes immunological and hematological disturbances, most notably CD4+ T-lymphocyte depletion and thrombocytopenia. Antiretroviral therapy (ART) suppresses viral replication and may restore both, but pediatric data comparing these parameters remain limited. Objective. To compare platelet and CD4 lymphocyte counts before and after six months of ART in children with HIV. Methods. An observational analytic study with a retrospective cohort approach used medical records of children (aged 0–18 years) with HIV (ICD-10 B20) treated at Haji Adam Malik General Hospital, Medan, from 2020 to 2025. ART-naive children with platelet and CD4 results within seven days before ART and at month six were included by consecutive sampling. Values were compared using the Wilcoxon signed-rank test (SPSS version 26.0); p<0.05 was considered significant. Results. A total of 74 children were analyzed (56.8% male; 45.9% good nutritional status; 75.7% without opportunistic infection). The most common regimen was zidovudine + lamivudine + nevirapine (28.4%). Median CD4 count rose from 429 to 503 cells/mm³ (p=0.002), whereas median platelet count rose from 304,000 to 323,000/µL without reaching significance (p=0.116). A positive directional relationship between the two parameters was observed after therapy. Conclusion. Six months of ART significantly increased CD4 lymphocyte count but not platelet count, largely because most children had normal baseline platelets. Routine complete blood counts alongside CD4 monitoring remain useful, and platelet count may serve as a simple adjunct marker of immune response.