Manifestations and Related Risk Factors of Thrombocyte Abnormalities in HIV-Positive Patients Before and After the Initiation of ART

Li, Bei; Zhang, Leidan; Liu, Ying; Xiao, Jiewen; Wang, Xinyue; Wei, Yuqing; Fan, Linyuan; Duan, Yujiao; Li, Guoli; Kong, Yaxian; Zhao, Hongxin

doi:10.2147/idr.s334046

Cited by 6 publications

(7 citation statements)

References 36 publications

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“…A few prior studies have reported the prevalence but not incidence of thrombocytopenia in children with HIV infection: Ellaurie et al [21] reported that 13% of CWH before the ART era had thrombocytopenia. Other studies, including adolescents and adults with HIV infection have reported a prevalence of thrombocytopenia of 10-30% [5,22], with thrombocytopenia associated with lower CD4 þ levels while thrombocytosis was associated with ART [23,24].…”

Section: Discussionmentioning

confidence: 97%

Risk factors and prognostic significance of platelet count abnormalities in children with HIV infection on antiretroviral therapy

Lubega

Kim

Airewele

et al. 2022

Aids

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Objectives: To establish the incidence, risk factors and correlation with survival of thrombocytopenia and thrombocytosis (T/T) among children with HIV infection (CWH).Design: A retrospective nested case control study of patients 0-18 years in five Baylor International Pediatric AIDS Initiative (BIPAI) centers in sub-Sahara Africa, 2004Africa, -2014 Methods: Clinical and laboratory variables including complete blood counts (CBC) were extracted from the BIPAI electronic medical record system. Incident cases of T/T were identified and frequency-matched on follow-up time with controls with normal platelets. We calculated the prevalence and incidence density of T/T and used conditional logistic regression to evaluate their association with selected clinical variables. We constructed Kaplan-Meier curves and a Cox proportional hazards model to evaluate the impact of T/T on survival.Results: Two thousand, one hundred and nine children were sampled. The incidence density of thrombocytopenia was 1 per 57.9 (95% confidence interval [CI] 50.3-66.8) CWHyears. Thrombocytopenia was higher in children with WHO Stage III/IV, lower in children on zidovudine, and had no association with use of lamivudine or nevirapine, CD4 þ suppression, age, and nutrition status. Thrombocytopenia was independently associated with 2.2-fold higher mortality (95% CI 1.62-3.08). The incidence density of thrombocytosis was 1 per 11.4 (95% CI 10.7-12.1) CWH-years. Thrombocytosis was associated with higher CD4 þ cell count, younger age, and use of lamivudine or nevirapine, and did not impact survival.Conclusions: Platelet count is a clinically valuable biomarker of HIV clinical progression and mortality. Laboratory studies are necessary to elucidate the mechanisms of T/T.

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Section: Discussionmentioning

confidence: 97%

Risk factors and prognostic significance of platelet count abnormalities in children with HIV infection on antiretroviral therapy

Lubega

Kim

Airewele

et al. 2022

Aids

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“…The prevalence was similar with HIV-1-associated tumor, HIV-1-associated fungal infection, but less than HIV-1-associated tuberculosis [17–20] . The findings indicated that thrombocytopenia occurred more frequently in HIV-1-infected patients, especially before the initiation of antiretroviral therapy, compared to the general population [1] . The majority of HAT patients were male, elderly, and with high COI.…”

Section: Discussionmentioning

confidence: 99%

“…Human Immunodeficiency Virus-1 (HIV-1) disrupts human immunity, leading to cancers and other opportunistic infections, etc. Anemia, leukopenia, and thrombocytopenia are complications of hematologic disorders that frequently accompany HIV-1 infection and AIDS [1] . The prevalence of HIV-1 associated thrombocytopenia (HAT), which can occur at any stage of the infection, ranges from 5.9% to 40% [2–4] .…”

Section: Introductionmentioning

confidence: 99%

Analysis of clinical manifestations and risk factors of HIV-1 associated thrombocytopenia in a general teaching hospital in western China

Tang

Wang

et al. 2022

Preprint

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Background: Thrombocytopenia is one of the hematologic disorders that frequently accompany HIV-1 infection. The interaction of HIV-1 and platelets is crucial in the Blood-Brain Barrier's (BBB) degeneration and causes neuroinflammation. The research aims to evaluate the prevalence and risk factors for HAT (HIV-1 associated thrombocytopenia) and summary the features of HAT-related neuroinflammation. Method: A retrospective study including 221 HAT patients was conducted in West China Hospital from 2017 to 2021. Clinical and laboratory data was analyzed the prevalence and risk factors for HAT and HAT-related neuroinflammation. Results: The prevalence of HAT was 11.06% and most patients were men (76.92%), elderly (≥50, 55.21%) and 63.80% patients were mild thrombocytopenia. CD4+T cell count, platelet crit (PCT) and the rate of large platelets (P-LCR) were significantly different between HAT group and control group (P<0.001, P<0.001, P=0.002). CD4+T cell count <200 cell/μL (P=0.001) was an important risk factor in the occurrence of HAT while advanced age and high viral load were closely related to the occurrence of HAT. HAT-related neuroinflammation patients were mostly distributed in male (X2=10.066, P=0.007), with higher viral load (X2=12.297, P=0.006) and advanced age (X2=11.721, P=0.02) with neuropsychiatric symptoms and rising level of inflammatory factors like IL-6 and proteins in CSF. Conclusion: HAT and HAT with neuroinflammation cannot be ignored in HIV-1 infection because of the activation of monocytes, macrophages and microglia, further causing thrombocytopenia and neuroinflammation. Advanced age, lower CD4+T cell count and high viral load were closely related to the occurrence of HAT and HAT-related neuroinflammation.

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“…Indeed, thrombocytopenia has been considered as a marker of disease progression and improvement [6]. Whereas platelet counts improve with initiation of combined antiretroviral therapy (cART) viral suppression [7], beneficial effect does not apply to zidovudin (AZT) [8].…”

Section: Hiv-associated Thrombocytopeniamentioning

confidence: 99%

“…Thrombocytosis is an emerging toxic complication accounting for 9% on stable cART depending on the regimen [7] up from 5.8% in treatment-naïve individuals [7]. It remains undetermined the relationship between HIV-associated thrombocytosis and accelerated thrombosis.…”

Section: Hiv-associated Thrombocytosismentioning

confidence: 99%

Challenges in Platelet Functions in HIV/AIDS Management

Ogweno¹

2023

Infectious Diseases

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The interest in platelet functions in HIV/AIDS is due to the high incidence of microvascular thrombosis in these individuals. A lot of laboratory data have been generated regarding platelet functions in this population. The tests demonstrate platelet hyperactivity but decreased aggregation, though results are inconsistent depending on the study design. Antiretroviral treatments currently in use display complex interactions. Many studies on platelet functions in these patients have been for research purposes, but none have found utility in guiding drug treatment of thrombosis.

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Manifestations and Related Risk Factors of Thrombocyte Abnormalities in HIV-Positive Patients Before and After the Initiation of ART

Cited by 6 publications

References 36 publications

Risk factors and prognostic significance of platelet count abnormalities in children with HIV infection on antiretroviral therapy

Risk factors and prognostic significance of platelet count abnormalities in children with HIV infection on antiretroviral therapy

Analysis of clinical manifestations and risk factors of HIV-1 associated thrombocytopenia in a general teaching hospital in western China

Challenges in Platelet Functions in HIV/AIDS Management

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