Neutropenia during HIV Infection: Adverse Consequences and Remedies

Abstract

Neutropenia frequently occurs in patients with Human immunodeficiency virus (HIV) infection. Causes for neutropenia during HIV infection are multifactoral, including the viral toxicity to hematopoietic tissue, the use of myelotoxic agents for treatment, complication with secondary infections and malignancies, as well as the patient’s association with confounding factors which impair myelopoiesis. An increased prevalence and severity of neutropenia is commonly seen in advanced stages of HIV disease. Decline of neutrophil phagocytic defense in combination with the failure of adaptive immunity renders the host highly susceptible to developing fatal secondary infections. Neutropenia and myelosuppression also restrict the use of many antimicrobial agents for treatment of infections caused by HIV and opportunistic pathogens. In recent years, HIV infection has increasingly become a chronic disease because of progress in antiretroviral therapy (ART). Prevention and treatment of severe neutropenia becomes critical for improving the survival of HIV-infected patients.

Neutrophils are essential for induction of vaccine-like effects by antiviral monoclonal antibody immunotherapies

“…First, if combination therapies are considered, it will be of utmost importance that the agent(s) coadministered with the passive immunotherapy do not alter neutrophil functions and counts to avoid inhibiting efficient antiviral humoral immune responses. Second, in pathological situations leading to neutropenia and/or impaired neutrophils functions, such as certain viral infections (68,69) and/or drug-induced neutropenia (70), it will be essential to restore them. This could, for example, be achieved through administration of granulocyte colony-stimulating factor (G-CSF), a cytokine already used in the clinic to treat neutropenic patients.…”

Pharmacodynamic studies of voriconazole: informing the clinical management of invasive fungal infections

“…[29]. Human immunodeficiency virus (HIV), infection is characterized by decreased immunocompetency and increased risk for neutropenia and fungal infection [32]. Respiratory illnesses such as tuberculosis or chronic obstructive pulmonary disease also predispose patients to IFI [8,33].…”

Diagnosis and management of primary autoimmune neutropenia in children: insights for clinicians

“…Nevertheless it must be emphasized that some infections, i.e. those caused by human immunodeficiency virus (HIV) or human hepatitis C virus (HCV), may be associated with long-lasting neutropenia [Sheehan et al 2013;Shi et al 2014]. …”