Anaemia is a common problem and increases in frequency with stage of HIV infection, ranging from 3% of asymptomatic patients to 12% of patients with CD4+ T cell counts of <200 cells/μL (or a CD4+ T cell percentage of <14% of lymphocytes) and 37% of patients with the acquired immunodeficiency syndrome (AIDS) in one large surveillance study.3 Anaemia has been associated with reduced survival in …
Thrombocytopenia is commonly observed in people with HIV infection with immune thrombocytopenic purpura (ITP) the most common cause of severe thrombocytopenia (platelet count < 30 x 10^9/L). It may occur in 30% or more of patients with AIDS13 and can occur at any time during HIV infection. In the antiretroviral era, risk factors include HIV viral load …
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Neutropenia is common in HIV infection (16% of patients in one study of over 130,00 individuals in a primary care setting) and should trigger testing for HIV infection. 18 Neutropenia may be due to HIV infection itself, autoimmune neutropenia, infections such as MAC and tuberculosis (TB), marrow infiltration by malignancy (commonly lymphoma), hypersplenism and drugs. Treatment …
An increase in immunoglobulin production occurs as part of the immune dysfunction caused by HIV infection and monoclonal paraproteins have been reported in as many as 7% of people with HIV infection. They do not appear to be clinically significant and may persist despite ART.20 Similarly, cryoglobulinaemia has been reported in HIV infection, again without clinical significance. Over 90% …
Thrombosis has been reported in up to 2% of people with HIV infection. Risk factors for this group are age over 45 years, advanced stage of HIV infection, co-existing opportunistic infections, hospitalisation, and therapy with indinavir and megestrol acetate.22 A number of potentially pro-thrombotic abnormalities have been reported in association with HIV infection, including decreased …
Bone marrow examination should be undertaken for any unexplained moderate-to-severe anaemia or isolated cytopenia or pancytopenia and for pyrexia of unknown origin where initial tests are unhelpful. Specimens should be sent for special microbial cultures, such as MAC, flow cytometry to examine to help exclude lymphoma, as well as for morphological examination.
Volberding PA, Baker KR, Levine AM. Human immune deficiency virus hematology. Hematology 2003; 2003:294-313. Choi SY, Kim I, Kim NJ et al. Hematological manifestations of human immunodeficiency virus infection and the effect of highly active anti-retroviral therapy on cytopenia. Korean J Hematol 2011; 46:253. Sullivan PS, Hanson DL, Chu SY et al.. Epidemiology of anemia …
James Pham1,2, Deshan Sebaratnam1,2 Faculty of Medicine and Health, University of New South Wales Department of Dermatology, Liverpool Hospital Last reviewed: Jan 2024 Next review due: March 2029 Acknowledgement: We would like to acknowledge Alexis Lara Rivero, Mark Kelly, Cassy Workman & Margot Whitfeld as the original authors of this section and David Wong for …
As with any clinical presentation, history taking may offer clues to diagnosis (Table 2). Note the distribution, type of rash and any other associated physical findings including: oral, hair, nail and genital changes Table 2 History essentials in the setting of cutaneous presentations HIV status Current and nadir CD4 cell count, and viral load results …
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Many viral infections, including those presenting with or limited to cutaneous involvement, occur more frequently in PLWHIV. (2) Common viral skin infections include those caused by Herpesviridae (including herpes simplex-1 and -2 and varicella zoster viruses), human papilloma viruses and Pox viruses. Given the underlying immunodeficiency in this demographic, viral infections may present atypically leading …