Rarick M U, Espina B, Montgomery T, Easley A, Allen J, Levine A M
Department of Internal Medicine, USC School of Medicine, Los Angeles 90033.
AIDS. 1991 Nov;5(11):1357-61. doi: 10.1097/00002030-199111000-00012.
Various treatments for HIV-related thrombocytopenia have been reported. Since etiologies of the thrombocytopenia may differ with regard to risk group treatment outcomes may also vary. We have recently studied the long-term use of zidovudine in individuals with sexually transmitted HIV infection and severe thrombocytopenia. Twenty-five men, median age 34 years (range, 23-51 years), were treated with zidovudine (1000 mg/day) for a median duration of 12 months (range, 2.5- less than 26 months). Nineteen patients (76%) had had episodes of symptomatic bleeding secondary to thrombocytopenia prior to study entry. All patients bleeding symptoms resolved with therapy. Six (24%) achieved a complete response, with normalization of platelet counts, while 11 patients (44%) achieved a partial response, giving an overall response rate of 68%. The median time to partial or complete normalization of platelet counts was 12 weeks (range, 4-62 weeks). Toxicities were minimal during the study period. Only one patient developed an AIDS-defining diagnosis while on therapy. We conclude that patients with sexually transmitted HIV infection and immune thrombocytopenia may need a prolonged period of therapy with zidovudine to achieve a platelet response. Other treatment modalities may be required for the 30% of patients who do not respond to zidovudine.
已有关于人类免疫缺陷病毒（HIV）相关血小板减少症的多种治疗方法的报道。由于血小板减少症的病因在不同风险组中可能有所不同，治疗结果也可能存在差异。我们最近研究了齐多夫定在性传播HIV感染且严重血小板减少症患者中的长期使用情况。25名男性，中位年龄34岁（范围为23 - 51岁），接受齐多夫定（1000毫克/天）治疗，中位疗程为12个月（范围为2.5 - 不到26个月）。19名患者（76%）在研究入组前曾有因血小板减少症导致的症状性出血发作。所有患者的出血症状经治疗后均得到缓解。6名患者（24%）达到完全缓解，血小板计数恢复正常，而11名患者（44%）达到部分缓解，总体缓解率为68%。血小板计数部分或完全恢复正常的中位时间为12周（范围为4 - 62周）。研究期间毒性反应极小。只有1名患者在治疗期间出现了艾滋病定义的诊断。我们得出结论，性传播HIV感染且免疫性血小板减少症患者可能需要长期使用齐多夫定治疗以获得血小板反应。对于30%对齐多夫定无反应的患者，可能需要其他治疗方式。
