Ann Clin Lab Sci 2015 ;45(1):23-6
Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
Previous reports have described the rare occurrence of detached nuclear fragments resembling Howell-Jolly bodies within neutrophils from HIV patients, organ-transplant recipients, and patients on immunosuppressive drugs. To date, their potential clinical significance is unknown, and pathologists tend to disregard their presence. Our study sought to find a correlation between these inclusions and the overall disease state, specifically within the HIV patient population. Eighty-three peripheral smears, all from different patients, were examined for the presence of inclusions and compared with recent CD4 counts and HIV RNA viral loads. Six cases contained inclusions, yielding a prevalence of 7.2%. These six patients had a mean CD4 count of 546±305 cells/μL compared to 247±242 cells/μL in those lacking inclusions (p<0.006) and viral loads of 1,686±3,446 copies/mL compared to 241,882±1,137,229 copies/mL in those lacking inclusions (p=0.6). These findings indicate that the presence of Howell-Jolly body-like inclusions may be viewed as a potential biomarker indicative of a low risk for disease progression and/or good response to therapy based upon higher CD4 counts and relatively favorable viral loads.
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