Majluf-Cruz A, Luna-Castaños G, Huitrón S, Nieto-Cisneros L
Department of Hematology, Hospital General Regional No. 1 Gabriel Mancera, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Am J Hematol. 1998 Oct;59(2):127-32. doi: 10.1002/(sici)1096-8652(199810)59:2<127::aid-ajh5>3.0.co;2-#.
Infection with the human immunodeficiency virus (HIV) frequently is complicated with thrombocytopenia (HIV-Thr) during all stages of the infection. The treatments for autoimmune thrombocytopenic purpura (ITP) are used in HIV-Thr; however, their effects upon the immune status of patients with acquired immunodeficiency syndrome (AIDS) are unknown. Intravenous immunoglobulin (IVIg) is used in patients with ITP and HIV-Thr; however, its usefulness in thrombocytopenic AIDS patients has not been directly addressed. We used a low-dose IVIg regimen (0.04 g/kg per week during five weeks) for the treatment of HIV-Thr complicating AIDS. Thirteen patients received IVIg. We observed a response to IVIg in 13 patients by the end of week one and in 10 patients by the end of week five. Long-term response, evaluated three months after stopping IVIg, was present in four cases. IVIg was well tolerated and no opportunistic infections were observed during the study period. Compared with previous reports, we used 10% of the previously proposed dosage with an important decrease in the cost of treatment. Our results suggest that this low-dose IVIg regimen is a highly effective, nonexpensive alternative in treating HIV-Thr in AIDS. If sustained responses can be obtained with a similar low-dose maintenance regimen, IVIg may be the first choice for the treatment of HIV-Thr in AIDS patients.
在人类免疫缺陷病毒（HIV）感染的各个阶段，常并发血小板减少症（HIV-Thr）。自身免疫性血小板减少性紫癜（ITP）的治疗方法被用于HIV-Thr的治疗；然而，它们对获得性免疫缺陷综合征（AIDS）患者免疫状态的影响尚不清楚。静脉注射免疫球蛋白（IVIg）用于ITP和HIV-Thr患者；然而，其在血小板减少的AIDS患者中的有效性尚未得到直接验证。我们采用低剂量IVIg方案（连续五周每周0.04 g/kg）治疗合并AIDS的HIV-Thr。13例患者接受了IVIg治疗。在第一周结束时，13例患者对IVIg有反应，在第五周结束时，10例患者有反应。在停止IVIg治疗三个月后评估的长期反应，有4例出现。IVIg耐受性良好，在研究期间未观察到机会性感染。与先前的报告相比，我们使用的剂量是先前建议剂量的10%，治疗成本大幅降低。我们的结果表明，这种低剂量IVIg方案是治疗AIDS患者HIV-Thr的一种高效、廉价的替代方法。如果用类似的低剂量维持方案能获得持续反应，IVIg可能成为AIDS患者HIV-Thr治疗的首选。
