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M94A2453.TXT
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1994-10-25
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Document 2453
DOCN M94A2453
TI Incidence of thrombocytopenia (TP) in HIV-infected injecting drug users
(IDUs). CDC International Collaborative Study.
DT 9412
AU Hershow RC; Fukuda K; Graber J; Vlahov D; Rezza G; Klein RS; Des Jarlais
D; Vitek C; Khabbaz R; Freels S; et al; Centers for Disease Control and
Prevention, NCID-DVRD, Atlanta,; GA 30333.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):300 (abstract no. PC0129). Unique
Identifier : AIDSLINE ICA10/94370122
AB OBJECTIVES: The incidence of HIV-related TP is not well characterized.
We examined the incidence of and factors related to TP (platelets < or =
100 x 10(9)/liter) in HIV-infected IDUs. METHODS: IDUs with defined HIV
seroconversion dates (last negative to first positive < or = 24 mos.)
were enrolled from 5 cohort studies. CD4 and platelet counts were
assayed serially. Time from seroconversion to TP was analyzed using
proportional hazards models, which assessed the association of TP with
seroconversion age, gender, HTLV-II coinfection, AZT, and CD4 counts.
RESULTS: The median duration of HIV-infection among 344 IDUs was 35 mos;
median seroconversion age (SCAGE) was 30.6 yrs, 73% were male and 20%
used AZT. Of the 344. 32 (9.0%) developed TP; 9 (2.6%) had severe TP
(platelets < 50 x 10(9)/liter). TP first occurred 0-24 mos. after HIV
-infection in 10 (31%), 25-48 mos. in 11 (34%), and > 48 mos. in 11
(34%). TP occurred at CD4 counts > 500 in 12 (37%), 200-500 in 13 (41%),
in < 200 for 7 (22%). In multivariate models, male gender and AZT use
(prior to TP) were associated with TP; SCAGE, CD4 counts, and HTLV-II
coinfection were not. In a model containing only gender and AZT, male
gender (RR = 6.7, p = 0.008) and AZT (RR = 3.5, p = 0.003) remained
significantly associated with TP. AZT had been used by 18% of men
compared to 24% of women (p = 0.18). CONCLUSIONS: The cumulative
incidence of TP is 9% in a cohort of HIV-infected IDUs; severe TP is
less common (2.6%). TP may occur early or late in HIV-infection and
emerges at mild or severe CD4 depletion. TP is associated with male
gender and AZT use. The AZT association is surprising since AZT is used
to treat TP. Further analyses are planned to explore this.
DE Adult Cohort Studies Female Human HIV
Infections/BLOOD/*COMPLICATIONS/TRANSMISSION Leukocyte Count Male
Platelet Count Substance Abuse, Intravenous/*COMPLICATIONS
Thrombocytopenia/*COMPLICATIONS T4 Lymphocytes MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).