THROMBOCYTOPENIA IN HIV INFECTED PATIENTS AND ITS CORRELATION WITH CLINICAL AND IMMUNOLOGICAL STATUS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2013, Vol 2, Issue 27
Abstract
[b] BACKGROUND[/b]: India had an estimated 1.8-2.9 million HIV positive persons in 2007 with an estimated adult prevalence of 0.34% (0.25% -0.43%).1Thrombocytopenia may occur as a result of HIV infection itself, as sequel of HIV related opportunistic infections or malignancies or autoimmune disease or as a consequence of therapies used for HIV infection and associated conditions. This study was undertaken as more patients with thrombocytopenia are identified and not much studies regarding thrombocytopenia are reported from this part of world.[b] OBJECTIVE[/b]: To study prevalence of thrombocytopenia in HIV patients and to analyze isolated thrombocytopenia and as part of bi or pancytopenia in correlation with clinical (presence of AIDS) and immunological (CD4 count) status. [b]MATERIALS AND METHOD[/b]: 100 cases of HIV positive patients were studied over a period of 2 years. Data was collected by using pre-tested proforma and all patients were interviewed, detailed history was taken and detailed physical examination was carried out. Appropriate investigations were carried out like complete haemogram including peripheral smear, bone marrow biopsy whenever indicated, CD4 lymphocyte counts and so on. Anemia was defined as Hb< 13g/dl in males and <12g/dl in females (WHO); Leukopenia <4000/µl and thrombocytopenia as <1.5 lakh/µl. CD4 count was measured using flow cytometry. [b]RESULTS[/b]: Of 100 patients, 75 were males and 25 were females. Thrombocytopenia was prevalent in 23% of patients. The mean platelet count was 2.04 ± 0.92 lakh/µl. The mean platelet count in patients with CD4>200 was 2.33 ± 1.02 lakh/µl and with CD4<200 was 1.86 ± 0.80 lakh/µl (p= 0.5660); patients with AIDS was 2.40 ± 1.03 and without AIDS was 1.96 ± 0.88 lakh/µl (p=0.0638). Isolated thrombocytopenia occurred early in disease course without CDC defined AIDS (p= 0.0185) and with higher CD4 count (p= 0.0110). [b]CONCLUSIONS[/b]: Thrombocytopenia was present in 23% of patients and occurred independent of clinical or immunological status. Of note isolated thrombocytopenia was independent of and occurred early in disease course. Thrombocytopenia as part of bicytopenia or pancytopenia developed in advanced disease.
Authors and Affiliations
Harsha M. M, Chaithra S. P
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