title: Clinical course of children with HIV associated thrombocytopenia.
abstract: OBJECTIVE
  To study the clinical profile of HIV associated thrombocytopenia, co-relation between thrombocytopenia and immune status and the effect of the anti-retroviral therapy (ART) on platelet count.
  
  
  METHODS
  In this cross sectional retrospective analytical study, records of all children up to 15 y, enrolled at a Pediatric ART Centre during the period 30 Nov. 2006 to 31st Dec. 2009 were reviewed for presence of thrombocytopenia. Clinical course, outcome and their immunological status were analyzed.
  
  
  RESULTS
  34 children (19.6%) out of 173 were found to have thrombocytopenia. After excluding three who had pancytopenia associated thrombocytopenia, records of 31 children (28 M, 3 F) were further studied. Six children (19.4%) presented with bleeding manifestations. The platelet counts ranged between 4x10(9)/L to 140x10(9)/L. No specific co-relation could be made out between platelet count and CD4 counts. The mortality was higher in thrombocytopenic children on ART as compared to children on ART with normal platelet count (p- < 0.001). Amongst the live children, the platelet counts normalized within 3 mo of ART in 11 (64.7%) while it took 18 mo in three and 30 mo in one case respectively. Twelve children with thrombocytopenia as an incidental finding have shown a good platelet response to ART. Six symptomatic children with thrombocytopenia showed a varied platelet response to ART despite showing a significant increase in the CD4 counts.
  
  
  CONCLUSIONS
  Thrombocytopenia in HIV infected may be an incidental finding in some children. Thrombocytopenia was found to be a poor prognostic factor and no specific co-relation to immune status was seen.
authors: Pediatric ART Centre, Department of Pediatrics, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi, 110001, India. pkpaed@gmail.com
authors: Praveen
authors: P
authors: Kumar
authors: Rohini A
authors: RA
authors: Gupta
authors: J
authors: J
authors: Chandra
authors: Anju
authors: A
authors: Seth
authors: S
authors: S
authors: Aneja
authors: A K
authors: AK
authors: Dutta
mesh_terms: D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D010976:Platelet Count; D011379:Prognosis; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000209:etiology* / Q000276:immunology
chemical_list: D019380:Anti-HIV Agents