HIV-Related Thrombocytopenia

Publisher Website
Google Scholar
Abstract
Ballem and colleagues (Dec. 17 issue)1 make important contributions to the understanding of human immunodeficiency virus (HIV)-related thrombocytopenia, emphasizing the role of decreased production of platelets, possibly due to viral infection of “neglected” megakaryocytes, as the accompanying editorial puts it2. We studied the survival of 111In-labeled autologous platelets in a group of intravenous drug users with HIV-related thrombocytopenia that was severe (3 platelets per cubic millimeter; 28 patients) or moderate (30 to 99 × 103 platelets per cubic millimeter; 24 patients)3,4. Although our mean results were similar to those reported by Ballem et al., there were also some important differences. Of the 52 patients, 48 had normal numbers of megakaryocytes in the bone marrow-biopsy specimen. Nine of them (19 percent) had severe reductions in platelet survival (to less than 72 hours), 21 (44 percent) had only slight decreases, and 18 (38 percent) had normal platelet survival with substantial reductions in the rate of platelet recovery, suggesting splenic or hepatic “pooling.”