title: Thrombocytopenia in HIV-infected and uninfected hemophiliacs. Multicenter Hemophilia Cohort study.
abstract: To determine the incidence and prognostic significance of thrombocytopenia among hemophiliacs, we analyzed clinical and hematologic data from the Multicenter Hemophilia Cohort study. Nineteen percent of HIV-infected subjects had thrombocytopenia (platelet count of <100,000/mm3) noted at least once, compared to 3% of HIV-uninfected subjects. For HIV-infected subjects, the prevalence of thrombocytopenia rose in the first 5 years after seroconversion and was twice as common in subjects age >35 years compared to younger subjects. The risk increased after an AIDS-defining illness, particularly among older subjects, nearly one-half of whom had thrombocytopenia within 1 year after AIDS. When adjusted for age and CD4-positive lymphocyte counts, thrombocytopenia was associated with an increased risk of death [relative risk (RR) 1.7, 95%CI = 1.2-2.3] but with little change in the risk of progression to AIDS (RR = 1.2, 95%CI = 0.8-1.7). Treatment with zidovudine was associated with a decreased risk of thrombocytopenia (RR = 0.5, 95%CI = 0.3-0.7). Although 59 HIV-infected subjects died of hemorrhage, only 11 (19%) of the 59 had a reported platelet count of <50,000/mm3, and only 2 (3%) of the deaths were temporally associated with thrombocytopenia. Thus, the risk of death was increased for thrombocytopenic HIV-infected hemophiliacs but this was not explained by an increased risk of developing AIDS and was rarely associated with death from bleeding.
authors.affiliation: Department of Medicine, Pennsylvania State University College of Medicine, Hershey 17033, USA.
authors.forename: W C
authors.initials: WC
authors.lastname: Ehmann
authors.forename: C S
authors.initials: CS
authors.lastname: Rabkin
authors.forename: M E
authors.initials: ME
authors.lastname: Eyster
authors.forename: J J
authors.initials: JJ
authors.lastname: Goedert
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D006679:HIV Seropositivity / Q000150:complications* / Q000503:physiopathology; D006467:Hemophilia A / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D013921:Thrombocytopenia / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology