"Kinetic Studies of the Mechanism of Thrombocytopenia in Patients With" Human Immunodeficiency Virus Infection

Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.

"Kinetic Studies of the Mechanism of Thrombocytopenia in Patients With" Human Immunodeficiency Virus Infection

New England Journal of Medicine (12/17/92) Vol. 327, No. 25, P. 1779
Ballem, Penny J. et al.

Abstract: Infection of megakaryocytes may be an important factor in HIV-related thrombocytopenia, causing decreased platelet production, write Penny J. Ballem et al. of St. Paul's Hospital and the University of British Columbia in Vancouver, British Columbia, Canada. The researchers examined the survival of In-labeled autologous platelets and performed platelet imaging in 24 men with isolated HIV-related thrombocytopenia (16 who received no treatment and 8 who received AZT). Mean platelet survival was significantly decreased in both the untreated and the AZT-treated patients with HIV-related thrombocytopenia, as compared with the normal controls. Mean platelet survival was also substantially reduced in the HIV-positive patients with normal platelet counts. But imaging studies revealed no evidence of increased clearance of autologous platelets in the liver or spleen in any of these groups. Mean platelet production was significantly depressed in the untreated patients with thrombocytopenia as compared with the healthy controls. However, mean platelet production was significantly increased in the men treated with AZT, both in those with thrombocytopenia and in those without thrombocytopenia. While there was a moderate decrease in platelet survival in HIV-positive subjects, these patients, despite platelet counts, also had decreased production of platelets, possibly as a result of viral infection of the megakaryocytes. The researchers concluded that AZT seems to improve platelet production.

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