title: Thrombocytopenia in HIV infected patients. Prevalence and clinical spectrum.
abstract: We studied the prevalence, clinical spectrum and epidemiologic features of thrombocytopenia among 442 (333 male, 109 female) HIV infected patients. Thrombocytopenia was defined as a platelet count < 100,000/mmc and severe if platelet count was < or = 30,000/mmc. Intravenous drug abusers were 83% (369/442). At the first clinical evaluation according to Walter-Reed (WR) classification, 90% (396/442) of patients were in stage 1-5 and 10% (45/442) in stage 6. Severe thrombocytopenia (platelet count < or = 30,000/mmc) was present in 24% (11/45) of the entire thrombocytopenic population. Forty percent (18/45) of the thrombocytopenic patients were positive to: HBV (6), HCV (7), HBV+HCV (5). Mild bleeding was present in 16% (7/45) of the patients but one case, with severe thrombocytopenia, died of intracranial hemorrhage. Major hemorrhagic sequelae with even fatal events are possible, especially when a low platelet count is associated with other hemostatic abnormalities (e.g. haemophilia, liver disease, disseminated intravascular coagulation). Zidovudine therapy (range 500-1250 mg/day) is effective in normalizing the platelet count (platelets > 100,000/mmc) only in 29% (9/31) of the patients.
authors.affiliation: Istituto di Malattie Infettive, Università, Perugia.
authors.forename: M
authors.initials: M
authors.lastname: Marroni
authors.forename: P
authors.initials: P
authors.lastname: Gresele
authors.forename: R
authors.initials: R
authors.lastname: Vezza
authors.forename: R
authors.initials: R
authors.lastname: Papili
authors.forename: D
authors.initials: D
authors.lastname: Francisci
authors.forename: G
authors.initials: G
authors.lastname: De Socio
authors.forename: F
authors.initials: F
authors.lastname: Di Candilo
authors.forename: F
authors.initials: F
authors.lastname: Baldelli
authors.forename: M
authors.initials: M
authors.lastname: Fiorio
authors.forename: F
authors.initials: F
authors.lastname: Longo
mesh_terms: D000328:Adult; D017809:Fatal Outcome; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D015497:HIV-1; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013921:Thrombocytopenia / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology