Epidemiology of thrombocytopenia in HIV inlection

Abstract

Thrombocytopenia is a known complication of human immunodeficiency virus Type‐I (HIV‐1) infection, and more data need to be collected on its frequency, severity, and clinical sequelae. We determined the frequency of thrombocytopenia and its relationship to other HIV infection characteristics from a review of records of 1004 HIV‐infected patients attending two outpatient clinics in Washington, D.C. The self‐reported sources of HIV‐1 exposure were male homosexual activity (68j, bisexual activity (10%), heterosexual activity (6%), and intravenous drug use (15%). Fifty‐nine percent of the individuals were white, 37% were black and 94% were male. Fifteen percent had AIDS. Thrombocytopenia occurred more frequently in subjects with AIDS (21.2%) than in HIV‐infected individuals who did not fit clinical criteria for AIDS (9.2%) (p<0.001). Patients with few CD4‐positive cells and an advanced stage of disease were more likely to have low platelet counts: 30% with an absolute CD4 cell count lower than 200/mm3vs 8 % with CD4 counts between 200 and 500 (p<0.00001), and 18.5yo with Stage IV disease compared to 7.6% in Stage I1 (p< 0.001) had platelet counts less than 150000/mm3. Thrombocytopenia was more frequent in white males and older subjects. Although subjects infected by heterosexual exposure had a lower frequency of thrombocytopenia, intravenous drug users and homosexual men exhibited similar frequencies of thrombocytopenia. Of all subjects with platelet counts less than 50000/mm3, 40% reported bleeding and 1 died of an intracranial hemorrhage. Thrombocytopenia occurs frequently in HIV‐infected people, primarily in those with AIDS, low CD4 cell numbers, and advanced stages of diseases

Thrombocytopenia in HIV-Infected Patients

“…There was a progression in Brazil toward heterosexual exposition, stable numbers of MSM and a decline of IVDU. A higher number of median CD4 cells counts could be seen in thrombocytopenic patients compared to other studies, in which low platelet counts are related to disease progression (AIDS) [4].…”

“…Bleeding episodes have been described in 75-82% of patients with those counts, although severe events are rare [4]. We could observe in 40% of patients bleeding episodes, and 23.7% needed platelet transfusion.…”

Comparison of platelet count in tuberculosis spine to other spine pathology

“…There are no similar papers comparing these groups in a TB spondylitis cohort at the time of publication. However Sloand et al [10] findings in 1004 HIV patients had a 30 % thrombocytopenic prevalence. That paper showed the higher the CD4 count, the higher the platelet count raises.…”

“…Baynes et al [9] noted reactive thrombocytosis in pulmonary TB. While HIV has been shown to cause thrombocytopaenia [10]. The only study done to the best of our knowledge on TB spondylitis and thrombocytosis is by Muzaffar TM et al Their cohort of 17 patients with TB spine had thrombocytosis in 52.9 % [11].…”

Thrombocytopenia during pregnancy in women with HIV infection receiving no treatment

“…[5] Severe TCP (≤50 × 10 9 /L) is rare, occurring in ≤0.1% of pregnancies. [6] In these cases, pathological causes of increased destruction or utilisation of platelets such as preeclampsia/eclampsia, the HELLP syndrome (haemolysis, elevated liver enzymes and low platelet count), and microangiopathies such as thrombotic thrombocytopenic purpura, (auto)immune thrombocytopenic purpura, haemolytic uraemic syndrome and haemolysis are likely. Viral infections such as viral hepatitis and infection with cytomegalovirus and HIV may also cause TCP.…”