Hematologic manifestations of infection with the Human Immunodeficiency Virus
Escudero, O.G.; Soberal, M.G; Mellado, R.H.
Boletin de la Asociacion Medica de Puerto Rico 91(1-6): 72-77
1999
ISSN/ISBN: 0004-4849 Document Number: 703024
HIV infection is associated with both infectious and non-infectious conditions that involve every organ system. Hematologic system may be affected in different ways: 90% of HIV-patients develop cytopenia. Of those involving white blood cell count, CD4 lymphopenia is almost universal; however, neutropenia may also been seen in 10-50% of cases. Causes involve decreased bone marrow production, or peripheral destruction by immune mechanisms. 80% of patients with HIV infection develop anemia at some point in the course of illness, and is a major predictor of disease progression; causes of anemia include bone marrow and cell progenitor toxicity induced by HIV, opportunistic infections, malignancy, medications, nutritional deficiencies, hypersplenism, and autoimmune forms of hemolytic anemia. Low platelet count may be the earliest hematologic manifestation of HIV infection, with an incidente of 40%, and thrombocytopenia correlates with a low CD4-T cell count; the major cause is ITP, although decreased platelet production secondary to bone marrow infiltration or toxicity may also be seen. Treatment modalities include correction of nutritional deficiencies, RBC transfussions and use of recombinant erythropoietin for anemia; zidovudine, IFN-alfa, IV gammaglobulin, anti-RH immunoglobulin, danazol, corticosteroids and splenectomy for ITP related to HIV, and appropiate use of colony stimulating factors for low neutrophil count, as well as to avoid using myelotoxic drugs that may induce any further blood cell dyscrasia.
Document emailed within 1 workday
