Department of Clinical Hematology, Health Sciences Center, Federal University of Santa Catarina, Florianópolis, SC, Brazil.
Acta Haematol. 2010;124(1):13-8. doi: 10.1159/000313782. Epub 2010 Jul 6.
The first thrombocytopenia cases related to the human immunodeficiency virus (HIV) were described even before its isolation in 1983. Subsequently, multiple mechanisms have been proposed to elucidate the etiology of thrombocytopenia. In addition to other types of cytopenia affecting patients with HIV, thrombocytopenia is observed in about 10-50% HIV patients as one of the first clinical signs of infection. Thus, in this review we aim to summarize the mechanisms proposed for thrombocytopenia since the discovery of HIV, and especially the innovations in the field in recent years. Among the different mechanisms suggested for HIV-related thrombocytopenia, there is emphasis on the accelerated destruction of platelets (PLTs) due to the action of immune complexes, and the presence of anti-PLT and anti-HIV antibodies that cross-react with the PLT membrane. There are also secondary causes of thrombocytopenia, such as the effect of drugs and opportunistic diseases associated with HIV.
早在 1983 年人类免疫缺陷病毒 (HIV) 被分离出来之前,就已经描述了与 HIV 相关的首例血小板减少症病例。随后,提出了多种机制来阐明血小板减少症的病因。除了影响 HIV 患者的其他类型细胞减少症外,血小板减少症在约 10-50%的 HIV 患者中作为感染的首发临床症状之一被观察到。因此,在这篇综述中,我们旨在总结自 HIV 发现以来提出的与 HIV 相关的血小板减少症的机制,特别是近年来该领域的创新。在提出的与 HIV 相关的血小板减少症的不同机制中,重点强调了由于免疫复合物的作用导致血小板 (PLT) 加速破坏,以及存在与 PLT 膜发生交叉反应的抗 PLT 和抗 HIV 抗体。此外,还有血小板减少症的继发性原因,如药物的影响和与 HIV 相关的机会性疾病。