Epidemiology of thrombocytopenia in HIV infection.
Thrombocytopenia is a known complication of human immunodeficiency virus Type-1 (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 (68%), 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 less than 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/mm3 vs 8% with CD4 counts between 200 and 500 (p less than 0.00001), and 18.5% with Stage IV disease compared to 7.6% in Stage II (p less than 0.001) had platelet counts less than 150,000/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 50,000/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.
Sloand
E M
EM
National Heart, Lung, and Blood Institute, Bethesda, MD 20892.
Klein
H G
HG
Banks
S M
SM
Vareldzis
B
B
Merritt
S
S
Pierce
P
P
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy / Q000635:transmission; D001803:Blood Transfusion; D001853:Bone Marrow / Q000473:pathology; D015496:CD4-Positive T-Lymphocytes / Q000473:pathology; D005260:Female; D015497:HIV-1; D006467:Hemophilia A; D006716:Homosexuality; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D015819:Substance Abuse, Intravenous; D013921:Thrombocytopenia / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D015215:Zidovudine / Q000627:therapeutic use
D015215:Zidovudine