Haematological Profiles of Newly Diagnosed HIV Patients Initiated on Dolutegravir-Based Therapy at the University of Nigeria Teaching Hospital, Enugu

Background Dolutegravir (DTG), an integrase strand transfer inhibitor, is increasingly adopted as the preferred first-line antiretroviral therapy (ART) due to its potent virological efficacy and high barrier to resistance. However, emerging safety concerns—such as reports of neural tube defects, neuropsychiatric symptoms, and hematological abnormalities including sideroblastic anemia—have raised important questions regarding its long-term safety profile. Objective This study evaluated the impact of DTG-based ART on hematological parameters in HIV-positive treatment-naïve individuals. Methods A total of 40 treatment-naïve HIV-positive adults (19 males, 21 females) without co-morbidities were prospectively recruited from the Antiretroviral Therapy Clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu, between January 2023 and July 2024. Forty age- and sex-matched HIV-seronegative individuals served as controls. Baseline socio-demographic were collected using a structured questionnaire. Blood samples were obtained at baseline and after six months of DTG-based ART initiation. Complete blood count (CBC) was assessed using an automated hematology analyzer. Results Following six months of DTG-based ART, there was a statistically Significant hematological changes were also observed post-treatment, including increases in lymphocyte count (40.92 ± 12.79%), red blood cell count (4.28 ± 0.89 × 10¹²/L), hemoglobin (11.44 ± 2.61 g/dL), hematocrit (34.19 ± 7.55%), mean corpuscular volume (80.33 ± 6.95 fL), mean corpuscular hemoglobin (26.4 ± 3.03 pg), and neutrophil count (51.53 ± 2.41%). No significant changes were observed in mean corpuscular hemoglobin concentration (MCHC), red cell distribution width-coefficient of variation (RDW-CV), or red cell distribution width-standard deviation (RDW-SD). Conclusion DTG-based ART was associated with significant alterations in several hematological indices and anthropometric parameters after six months of therapy. These findings highlight the need for ongoing hematologic monitoring and long-term safety surveillance in patients receiving DTG-based regimens.