[Epidemiology, clinical course++, prognosis and treatment of thrombocytopenia associated with human immunodeficiency virus type 1 infection: analysis of 41 cases].
BACKGROUND
Thrombocytopenia is one of the manifestations of infection by the human immunodeficiency virus-1 (HIV-1). A series of 41 patients were studied over a period of 2 years.


METHODS
The study was prospectively carried out with a control group of 80 patients with the epidemiology, clinical manifestations, prognosis and treatment of this process being evaluated.


RESULTS
The risk groups were: intravenous drug users (IVDU) (78%), homosexuals (12%) and heterosexuals (7%), patients with thrombocytopenia as the only manifestation (group IV-E) constituted the largest group with 30 cases. In 50% of the patients both diseases (thrombocytopenia and HIV infection) were simultaneously diagnosed. Nine patients (22%) vs 35% in the control group evolved to more advanced stages of the infection. Only 39% of the cases had hemorrhagic manifestations being more frequent in the IV-E group (47%) than in the remaining patients (18%). With regards to treatment, only 1 case responded completely with danazol. Steroids had variable, although evaluable, results with minimum secondary effects. The infusion of gammaglobulins achieved 80% of complete, although transitory, responses. Zidovudine obtained a positive response in 17/25 cases. Finally, splenectomy was performed in three patients definitively resolving the thrombocytopenia.


CONCLUSIONS
In thrombocytopenia associated with human immunodeficiency virus-1 (HIV-1) infection the distribution by groups of risk is equal to that of the rest of infected patients. Appearing early in the natural history of HIV infection, thrombocytopenia presents few clinical manifestations and does not constitute a factor of bad prognosis. The treatment of choice is zidovudine at doses of 500 mg/day.
Domínguez Castellano
A
A
Servicio de Medicina Interna y Hematología, Hospital La Paz, Madrid.
Peña
J M
JM
López Pastor
A
A
González
J
J
Martín
R
R
Vázquez
J J
JJ
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D005260:Female; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013921:Thrombocytopenia / Q000150:complications* / Q000453:epidemiology / Q000628:therapy
Epidemiología, clínica, pronóstico y tratamiento de la trombocitopenia asociada a la infección por el virus de la inmunodeficiencia humana tipo 1: análisis de 41 casos.