The long-term use of zidovudine in patients with severe immune-mediated thrombocytopenia secondary to infection with HIV.
Various treatments for HIV-related thrombocytopenia have been reported. Since etiologies of the thrombocytopenia may differ with regard to risk group treatment outcomes may also vary. We have recently studied the long-term use of zidovudine in individuals with sexually transmitted HIV infection and severe thrombocytopenia. Twenty-five men, median age 34 years (range, 23-51 years), were treated with zidovudine (1000 mg/day) for a median duration of 12 months (range, 2.5- less than 26 months). Nineteen patients (76%) had had episodes of symptomatic bleeding secondary to thrombocytopenia prior to study entry. All patients bleeding symptoms resolved with therapy. Six (24%) achieved a complete response, with normalization of platelet counts, while 11 patients (44%) achieved a partial response, giving an overall response rate of 68%. The median time to partial or complete normalization of platelet counts was 12 weeks (range, 4-62 weeks). Toxicities were minimal during the study period. Only one patient developed an AIDS-defining diagnosis while on therapy. We conclude that patients with sexually transmitted HIV infection and immune thrombocytopenia may need a prolonged period of therapy with zidovudine to achieve a platelet response. Other treatment modalities may be required for the 30% of patients who do not respond to zidovudine.
Rarick
M U
MU
Department of Internal Medicine, USC School of Medicine, Los Angeles 90033.
Espina
B
B
Montgomery
T
T
Easley
A
A
Allen
J
J
Levine
A M
AM
D000328:Adult; D004361:Drug Tolerance; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011379:Prognosis; D013921:Thrombocytopenia / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D013997:Time Factors; D015215:Zidovudine / Q000009:adverse effects / Q000627:therapeutic use*
D015215:Zidovudine