VPB1221 - A retrospective analysis of 45 cases of HIV-associated thrombocytopenia in a single center over ten years

Background: Thrombocytopenia is one of the most common hematological complications of HIV infection.Prior to the advent of highly active antiretroviral therapy (HAART), the incidence of HIV-associated thrombocytopenia was estimated at 10–30%.

Aims: To analyze the clinical characteristics and treatment effects of patients with HIV infection combined with thrombocytopenia.

Methods: To retrospectively analyze the clinical manifestations and medical records of 45 patients diagnosed with HIV/AIDS combined with thrombocytopenia in the Department II of Infectious Diseases of Yunnan Infectious Diseases Specialist Hospital between January 2010 and December 2020. Comparing the therapeutic effects of different treatment and exploring the factors affecting platelet counts in HIV patients.

Results: (1)The median platelet count at admission was 10 (0-64×109/L) in 45 cases, and 31 patients had a platelet count < 20×109/L. (2) 1 month after treatment, the median platelet count of patients was 37 (4-309) × 109 /L, and the median time to reach R was 26 (12-44) days.The total follow-up time was 79 (14-368) days, 18 patients did not respond to treatment, 12 patients experienced relapse during the follow-up period, and the median platelet count of 14 patients was 148 (104-230) × 109 /L as of the last follow-up time,different protocols have different treatment responses（Figure 1）.(3)The number of CD4+ T cells at the initial diagnosis had no significant effect on platelet count, treatment effect, nor relapse rate (Z=-0.104,P=0.917; χ2=0.015, P=0.901; χ2=1.361, P=0.243). (4) Bleeding score was significantly lower in hepatitis B patients compared with uninfected patients (Z=-2.504,P=0.011). Platelet count was significantly lower in hepatitis C positive patients compared with uninfected patients (Z=-2.855,P=0.003). The risk of bleeding was less in HIV patients than in uninfected patients when platelets were reduced.（Figure 2）

Conclusion(s): Patients with HIV combined with thrombocytopenia have a low response rate to treatment and tend to relapse. Hepatitis C virus infection was significantly associated with thrombocytopenia.