- 1-yr incidence ranges from 1.7% with asymptomatic HIV to 3.1% with CD4-define AIDS to 8.7% with AIDS-defining illness.
- Increased risk with decreasing CD4, injection drug use, African-American race, anemia. Other causes include alcohol abuse, sulfonamides, thiazides, folate and vitamin B12 deficiency, IV cocaine, and liver cirrhosis / portal hypertension.
- Direct effects of HIV on hematopoietic progenitors and idiopathic thrombocytopenic purpura (ITP) are major causes. In the latter, production of autoantibodies against certain platelet antigens (PA-IgG) leads to antibody-coated platelets removed by macrophages in the spleen.
- Increased risk of bleeding with PLT < 10,000-20,000.
- Heparin-induced thrombocytopenia may be more common in HIV-infected than uninfected.
- Uncommon with current ART (1-3% with plt < 50,000); more common if uncontrolled HIV replication and with viral hepatitis coinfection
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Last updated: March 12, 2023
Vogt, Samantha, and Richard D Moore. "Thrombocytopenia." Johns Hopkins HIV Guide, 2023. Johns Hopkins Guides, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545203/1/Thrombocytopenia.
Vogt S, Moore RD. Thrombocytopenia. Johns Hopkins HIV Guide. 2023. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545203/1/Thrombocytopenia. Accessed December 6, 2023.
Vogt, S., & Moore, R. D. (2023). Thrombocytopenia. In Johns Hopkins HIV Guide https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545203/1/Thrombocytopenia
Vogt S, Moore RD. Thrombocytopenia [Internet]. In: Johns Hopkins HIV Guide. ; 2023. [cited 2023 December 06]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545203/1/Thrombocytopenia.
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