Infection and Drug Resistance (Nov 2021)

Manifestations and Related Risk Factors of Thrombocyte Abnormalities in HIV-Positive Patients Before and After the Initiation of ART

  • Li B,
  • Zhang L,
  • Liu Y,
  • Xiao J,
  • Wang X,
  • Wei Y,
  • Fan L,
  • Duan Y,
  • Li G,
  • Kong Y,
  • Zhao H

Journal volume & issue
Vol. Volume 14
pp. 4809 – 4819

Abstract

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Bei Li,1 Leidan Zhang,2 Ying Liu,1 Jing Xiao,2 Xinyue Wang,2 Yuqing Wei,1 Lina Fan,3 Yujiao Duan,1 Guoli Li,4 Yaxian Kong,4 Hongxin Zhao1 1Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Infection, Beijing Ditan Hospital, Peking University, Beijing, People’s Republic of China; 3Department of Infectious Disease, The Tianjin Second People’s Hospital, Tianjin, People’s Republic of China; 4Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Hongxin ZhaoClinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, No. 8 Jing Shun East Street, Beijing, 100015, People’s Republic of ChinaEmail [email protected]: At present, the thrombocyte abnormality is not well described before and after the initiation of antiretroviral therapy (ART). The purpose of this research is to investigate the dynamic changes and related risk factors of thrombocytopenia and thrombocytosis in HIV-infected individuals.Methods: We performed a real-world observational study among 6637 HIV patients who started ART from January, 2013 to August, 2020 at the Beijing Ditan Hospital. Hazard indicators linked with thrombocytopenia and thrombocytosis were analyzed by logistic/Cox regression.Results: The prevalence of thrombocytopenia and thrombocytosis was 2.65% and 5.85% among ART-naïve patients, respectively. Correlated risk factors: (thrombocytopenia) older age, coinfection with HBV, leucopenia, anemia, and CD4 count < 350 cells/uL; (thrombocytosis) WBC level ≥ 4.0 x 109/L, anemia, NLR ≥ 2.0, and CD4 count ≥ 350 cells/uL. As for the recovery rate, it was 86.6/54.2, 83.4/46.3, 66.0/35.1, and 65.3/ 33.9 per 100 PYFU in thrombocytopenia/thrombocytosis at different treatment period (12m, 24m, 36m, and 48m). While the new-onset incidence of thrombocytopenia/thrombocytosis at different ART period (12m, 24m, 36m, 48m, 60m, 72m, and 84m) was 0.25/7.2, 0.19/6.31, 0.16/4.74, 0.16/4.55, 0.16/4.48, 0.15/4.41, and 0.15/4.39. And the driving forces of thrombocytosis were antiretroviral treatment, female, overweight, and WBC level ≥ 4.0 x 109/L.Conclusion: In the medical practice, while paying attention to thrombocytopenia, clinicians should be highly vigilant about the thrombocytosis of HIV/AIDS patients, and related treatment strategies need to be further studied.Keywords: thrombocyte abnormalities, thrombocytopenia, thrombocytosis, HIV, antiretroviral therapy

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