Thrombocytopenia in HIV-infected drug users in the HAART era.
The present case-control study compared 26 HIV+ drug users having persistent thrombocytopenia (TCP<150 000/mm(3)) with 54 available age, gender and HIV CDC classification matched controls with normal platelet counts. Participants were followed longitudinally over a 2-year period (1998-2000), and hematological alterations evaluated in relationship to antiretroviral treatment, drug use and nutritional (selenium) status. Demographic information and medical history, including antiretroviral treatment were obtained. Blood was drawn for complete cell blood count, T lymphocytes and viral load. Sixty-nine percent of the individuals with persistent TCP and 49% of the controls were receiving antiretrovirals. At baseline, no significant differences in CD4 existed between the two groups. Over time, CD4 cell count declined in the cases (P = 0.05) and a significantly higher proportion of the cases (38%) developed AIDS (CD4<200 cell/mm(3)), as compared to the controls (18%, P = 0.004). A high risk for development of thrombocytopenia was observed with specific drug use (heroin 2.96 times, P = 0.0007), selenium levels below 145 microg/l (6 times, P = 0.008), and abnormal liver enzyme (SGOT) levels (2 times, P = 0.002). Together, these results indicate a number of factors that may be sensitive predictors of thrombocytopenia, which, despite antiretroviral treatment, appears to be related to more rapid disease progression in drug users.
Burbano
X
X
University of Miami School of Medicine, Division of Disease Prevention, Department of Psychiatry and Behavioral Sciences, Miami, Florida 33136, USA.
Miguez
M J
MJ
Lecusay
R
R
Rodriguez
A
A
Ruiz
P
P
Morales
G
G
Castillo
G
G
Baum
M
M
Shor-Posner
G
G
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001219:Aspartate Aminotransferases / Q000009:adverse effects / Q000032:analysis; D018791:CD4 Lymphocyte Count; D018414:CD8-Positive T-Lymphocytes; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010976:Platelet Count; D012643:Selenium / Q000032:analysis; D015819:Substance Abuse, Intravenous / Q000150:complications*; D013921:Thrombocytopenia / Q000150:complications*; D019562:Viral Load
D001219:Aspartate Aminotransferases; D012643:Selenium