John Melanie-Anne A, Rhemtula Yasin A, Menezes Colin N, Grobusch Martin P
Infectious Diseases Unit, Division of Clinical Microbiology and Infectious Diseases, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Department of Internal Medicine, Helen Joseph Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
J Med Microbiol. 2008 Aug;57(Pt 8):1032-1035. doi: 10.1099/jmm.0.47782-0.
Anaemia is frequent in patients with human immunodeficiency virus infection, and antiretroviral drugs have been implicated. Whilst therapy-induced anaemia is more readily attributed to zidovudine, lamivudine-associated, potentially life-threatening, pure red cell aplasia (PRCA) has been less recognized in the past and is only infrequently documented in the literature. We report on a patient suffering from what turned out to be lamivudine-induced PRCA who required 15 units of blood within 3 weeks before recovering swiftly following lamivudine (3TC) treatment withdrawal. As reviewed here, the nature of this condition is not well described in general, the onset appears to be variable and occurs at any CD4(+) count, but rapid improvement after cessation of drug administration appears to be a consistent feature.
贫血在人类免疫缺陷病毒感染患者中很常见，抗逆转录病毒药物被认为与之有关。虽然治疗引起的贫血更容易归因于齐多夫定，但过去对拉米夫定相关的、可能危及生命的纯红细胞再生障碍性贫血（PRCA）认识较少，文献中也很少有记载。我们报告了一名患者，其最终被诊断为拉米夫定诱导的PRCA，在停用拉米夫定（3TC）治疗前3周内需要输注15个单位的血液，停药后迅速康复。如本文所述，这种情况的本质一般描述得并不清楚，发病似乎具有可变性，可发生于任何CD4(+)细胞计数时，但停药后迅速改善似乎是一个一致的特征。
