Abstract

Hematological abnormalities are frequent in newly diagnosed people living with HIV (PLWH), yet their prognostic significance remains incompletely defined. We conducted a retrospective single-center cohort study including newly diagnosed PLWH evaluated between 2018 and 2024 and analyzed hematological, immunological, virological, and inflammatory parameters at diagnosis and after 12 months of antiretroviral therapy (ART). Most patients presented with advanced HIV disease and severe immunosuppression. Anemia was the most frequent hematological abnormality and was associated with lower CD4 counts, higher HIV viral load, and reduced survival. Elevated C-reactive protein (CRP) levels and the presence of multiple cytopenias were also associated with poorer outcomes. Notably, patients with two or more cytopenias had significantly reduced overall survival, suggesting that multilineage hematopoietic impairment may reflect advanced systemic disease. Significant hematological and immunological recovery was observed after 12 months of ART. These findings indicate that hematological abnormalities in newly diagnosed HIV infection reflect the interplay between immune dysfunction, systemic inflammation, and impaired hematopoiesis. Multiple cytopenias may serve as readily accessible prognostic biomarkers and could improve early risk stratification in PLWH.

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