Cytopenias - I. Thrombocytopenia
HIV-infected patients frequently develop hematologic abnormalities. Cytopenias often respond to suppression of HIV with antiretrovirals, treatment of infectious diseases and tumors, discontinuation or dosage reduction of myelosuppressive medications, correction of nutritional deficiencies, and treatment with hematopoietic growth factors or other cytokines.
I. Thrombocytopenia
A. Causes of thrombocytopenia include myelosuppression from medications, infections or tumors and increased destruction of cells (disseminated intravascular coagulation, thrombotic thrombocytopenic purpura, immune mediated thrombocytopenia). Platelet counts may respond to anti-HIV therapy with antiretroviral drugs, immunoglobulin therapy, splenectomy, vincristine, prednisone, danazol, or alpha interferon.
B. Discontinuation of myelosuppressive medications and treatment of infections and tumors may also reduce thrombocytopenia. Plasma exchange has been effective for TTP.