Platelets and People: Comparing Thrombocyte Patterns in African and Russian HIV Cohorts– A Review

Abstract

Platelet abnormalities are common hematological manifestations of HIV infection, yet their patterns vary across regions due to differences in comorbidities, treatment access, and population-specific physiological baselines. Africa and Russia represent two distinct HIV epidemics with unique epidemiological drivers and hematologic reference norms. Understanding how platelet indices differ between these settings is essential for improving diagnostic accuracy and patient management. This review synthesizes evidence on thrombocyte patterns among HIV-positive cohorts in Africa and Russia, with emphasis on thrombocytopenia, regional baseline platelet reference ranges, and the influence of co-infections and treatment status. A narrative review was conducted through searches in PubMed, Scopus, Web of Science, and AJOL for studies published between 1990 and 2025. Observational and cohort studies reporting platelet indices in HIV-infected adults or children from African or Russian populations were included. Findings show that thrombocytopenia is more prevalent in African HIV cohorts, often driven by immune-mediated platelet destruction, opportunistic infections, and endemic co-infections such as malaria and tuberculosis. Russian cohorts exhibit platelet abnormalities more frequently linked to late HIV diagnosis, hepatitis C co-infection, and substance use–related complications. Regional platelet reference ranges differ considerably, with African populations generally showing lower baseline values than Russian or global standards, impacting diagnostic thresholds and disease classification. Platelet patterns in HIV infection vary markedly between Africa and Russia due to distinct epidemiologic and healthcare factors. Context-specific reference ranges and diagnostic criteria are essential for accurate monitoring and improved clinical decision-making.