Olariu Mihaela Cristina, Iancu Mihaela Adela, Olariu Mihai Hristu, Aramă Victoria, Simoiu Mădălina, Cruceru Miruna Maria, Barbu Ecaterina Constanta, Balanescu Paul, Lazar Mihai
Department of Infectious Diseases, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
"Matei Bals" National Institute of Infectious Diseases, 021105 Bucharest, Romania.
Trop Med Infect Dis. 2024 Sep 13;9(9):213. doi: 10.3390/tropicalmed9090213.
Cytopenias or coagulation deficiencies can occur in people living with HIV (PLWH). The severity of these disorders is influenced by the low levels of CD4+ lymphocytes, viral load, and the stage of viral infection. The aim of our retrospective observational study was to determine the frequency of cytopenias and coagulation deficiencies in PLWH as well as the need for replacement therapy with blood products. We sought to determine whether there is an association between severe anemia or thrombocytopenia (requiring replacement therapy) and CD4+T lymphocyte levels. All 29 patients were critically ill, with 27 out of 29 (93%) in advanced stages of HIV disease and 23 out of 29 (79%) having CD4+ lymphocyte counts below 200 cells/microL. Most patients were either late presenters (45%) or had been lost to follow-up (41%). In addition to HIV infection, various conditions that could alter hematologic parameters were associated, including co-infections with hepatitis viruses, tuberculosis at various sites, malignant diseases, sepsis, SARS-CoV-2 infection, or other opportunistic infections. No significant correlation was found between severe anemia or severe thrombocytopenia or coagulation deficiencies and the CD4+T lymphocyte count. Our data suggest that these hematological disorders in patients with advanced HIV infection are more likely to be associated comorbidities rather than the HIV infection per se.
HIV感染者(PLWH)可能会出现血细胞减少或凝血功能缺陷。这些病症的严重程度受CD4+淋巴细胞水平、病毒载量和病毒感染阶段的影响。我们这项回顾性观察研究的目的是确定PLWH中血细胞减少和凝血功能缺陷的发生率以及血液制品替代治疗的必要性。我们试图确定严重贫血或血小板减少(需要替代治疗)与CD4+T淋巴细胞水平之间是否存在关联。所有29例患者均病情危重,29例中有27例(93%)处于HIV疾病晚期,29例中有23例(79%)的CD4+淋巴细胞计数低于200个/微升。大多数患者要么就诊较晚(45%),要么失访(41%)。除HIV感染外,还存在各种可能改变血液学参数的情况,包括合并感染肝炎病毒、不同部位的结核病、恶性疾病、败血症、SARS-CoV-2感染或其他机会性感染。未发现严重贫血或严重血小板减少或凝血功能缺陷与CD4+T淋巴细胞计数之间存在显著相关性。我们的数据表明,晚期HIV感染患者的这些血液学疾病更可能与合并症有关,而非HIV感染本身。