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J Acquir Immune Defic Syndr. 2009 Dec;52(5):595-9. doi: 10.1097/QAI.0b013e3181b79aff.

Risk factors for thrombocytopenia in HIV-infected persons in the era of potent antiretroviral therapy.

Author information

  • 1Division of Infectious Diseases, Department of Medicine, Weill Cornell Medical College, New York, NY 10065, USA. markskr@med.cornell.edu

Abstract

OBJECTIVE:

Before potent antiretroviral therapy, thrombocytopenia was observed frequently. Little is known about risk factors for or severity and consequences of thrombocytopenia since establishment of highly effective therapy for HIV.

METHODS:

We conducted a retrospective-matched case-control study of HIV-infected adult outpatients with and without thrombocytopenia to elucidate the contribution of HIV viremia, hepatitis C infection, and other potential risk factors for thrombocytopenia. Seventy-three cases with thrombocytopenia (platelet count <100 x 10(9)/L persistent for >3 months) were matched by age, sex, and first clinic visit with 73 nonthrombocytopenic controls. Risk factors and outcomes were assessed using conditional logistic regression.

RESULTS:

Nadir platelet counts in cases were <or=50 x 10(9)/L in 58% and <or=30 x 10(9)/L in 38%. In multivariate modeling, HIV RNA >400 copies/ml, hepatitis C virus infection, and cirrhosis were significantly associated with thrombocytopenia with adjusted odds ratios of 5.3 [confidence interval (CI) 1.6-17.1, P = 0.006], 6.1 (CI 1.6-22.6, P = 0.007), and 24.0 (CI 1.7-338, P = 0.019), respectively. Thrombocytopenia was significantly associated with major bleeding events and nonbleeding-related death.

CONCLUSIONS:

Thrombocytopenia in the era of potent antiretroviral therapy is associated with hepatitis C virus infection, cirrhosis, and uncontrolled HIV replication, and serious complications including major bleeding and death.

PMID:
19734800
[PubMed - indexed for MEDLINE]
PMCID:
PMC2787779
Free PMC Article
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