Neutropenia

CLINICAL

• Multiple causes, including HIV infection, inflammatory cytokines, drugs (AZT, ganciclovir, foscarnet, amphotericin, flucytosine, sulfonamides, pyrimethamine, pentamidine, interferon-alfa), OIs with bone marrow replacement, chemotherapy for malignancy.
• HIV can cause decreased growth of progenitor cell, CFU-GM; decreased endogenous G-CSF.
• Prevalence ranges from 10% in asymptomatic HIV, 40-50% with AIDS.
• Increased risk of bacterial and fungal infection with absolute neutrophil count (ANC) < 750, but absolute risk relatively low. Greatest risk for infection and hospitalization with ANC < 500.
• Neutropenia (< 1000) not associated with decreased survival in HIV+ women (possibly in men, but not studied)