Interconnected Hematologic and Infectious Manifestations in Human Immunodeficiency Virus: A Retrospective Cross-sectional Study of Immune Suppression

BACKGROUND: Human immunodeficiency virus (HIV) infection exerts multisystemic effects beyond immune depletion, disrupting hematologic, hepatic, and metabolic balance through chronic inflammation and viral toxicity. However, regional data integrating these systemic alterations remain scarce. This study aimed to evaluate the hematologic, hepatic, and infectious profiles of HIV-positive patients and to examine their association with CD4⁺ T-cell counts. MATERIALS AND METHODS: A retrospective cross-sectional analysis was conducted on 250 HIV-positive patients attending a regional hospital between 2019 and 2024. Hematologic indices, liver enzymes, and infection status were assessed and correlated with CD4⁺ counts. Nonparametric tests and Spearman’s correlation were applied; P < 0.05 was considered statistically significant. RESULTS: Anemia was observed in 25.3% of patients, predominantly with microcytic–hypochromic features, and was significantly associated with lower CD4⁺ counts (<200 cells/µL). Opportunistic infections affected 52.8% of participants, with candidiasis (81.8%) and tuberculosis (18.2%) being the most common. Liver abnormalities were frequent among immunocompromised patients. Lower CD4⁺ counts were significantly associated with higher bilirubin and aspartate aminotransferase levels ( P < 0.01), whereas alanine aminotransferase and creatinine showed no significant correlations. hepatitis C virus (HCV) coinfection was detected in 3.6% of patients. CONCLUSION: HIV-related anemia, liver dysfunction, and opportunistic infections are interconnected systemic effects of immune suppression. Hemoglobin levels can serve as practical indicators of disease progression in resource-limited settings. Integrated management that targets inflammation, metabolic balance, and organ protection is essential to reduce morbidity among people living with HIV.