Hassan A, Babadoko A A, Mamman A I, Ahmed S A
Department of Haematology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
Niger J Med. 2009 Jul-Sep;18(3):332-3. doi: 10.4314/njm.v18i3.51210.
Zidovudine, a Nucleoside Reverse Transcriptase Inhibitor (NRTI) is one of the earliest antiretroviral agents used as a combination in the Highly Active Antiretroviral Therapy (HAART) for the treatment of HIV infection. Its use is however not without adverse effect particularly bone marrow aplasia leading to varying degrees of cytopenias predominantly anaemia. This calls for adequate evaluation and monitoring of patients on this drug. Its major side effect of anaemia limits its use in some patients. We report a case of Zidovudine induced anaemia and bone marrow aplasia in a patient infected with HIV.
The Hospital case note of a 27 year old widow with HIV infection and anaemia, who has been on HAART (Zidovudine, Lamivudine and Nevirapine) for one year, was reviewed.
She presented with severe anaemia (PCV of 0.05), White cell and platelet counts were within normal limits and reticulocyte count of 0.001%. Bone marrow aspiration and biopsy were diagnostic of pure red cell aplasia on a background hypocellular marrow. She was transfused with four (4) units of packed cells and Zidovudine was replaced with Stavudine. She made remarkable improvement and remains transfusion independent afterwards.
Zidovudine is well a known cause of anaemia and thus should be used with caution in the initiation of antiretroviral therapy.
齐多夫定，一种核苷类逆转录酶抑制剂（NRTI），是最早用于高效抗逆转录病毒治疗（HAART）联合治疗HIV感染的抗逆转录病毒药物之一。然而，其使用并非没有不良反应，特别是骨髓再生障碍，导致不同程度的血细胞减少，主要是贫血。这就需要对使用该药物的患者进行充分评估和监测。其主要副作用贫血限制了其在一些患者中的使用。我们报告一例HIV感染患者齐多夫定诱导的贫血和骨髓再生障碍病例。
回顾了一名27岁感染HIV且患有贫血的寡妇的医院病历，她接受HAART（齐多夫定、拉米夫定和奈韦拉平）治疗一年。
她表现为严重贫血（红细胞压积为0.05），白细胞和血小板计数在正常范围内，网织红细胞计数为0.001%。骨髓穿刺和活检诊断为以骨髓细胞减少为背景的纯红细胞再生障碍。给她输注了4单位浓缩红细胞，并用司他夫定替代了齐多夫定。她有显著改善，此后不再需要输血。
齐多夫定是贫血的已知病因，因此在开始抗逆转录病毒治疗时应谨慎使用。
