Prevalence of Thrombocytopenia among Chinese Adult Antiretroviral-naïve HIV-positive Patients

• Published in: Chinese medical journal 2015-02, Vol.128 (4), p.459-464
• Main Authors: Fan, Hong-Wei, Guo, Fu-Ping, Li, Yi-Jia, Li, Ning, Li, Tai-Sheng
• Format: Article
• Language: English
• Subjects: Adult; Age; Anemia; Antiretroviral drugs; CD4 Lymphocyte Count; Complications and side effects; Cross-Sectional Studies; Cytomegalovirus; Disease transmission; Distribution; Drug therapy; Female; Hematology; Hepatitis; Hepatitis C Antibodies - blood; HIV; HIV infections; HIV Infections - blood; HIV Infections - epidemiology; HIV Infections - immunology; HIV patients; HIV; Prevalence; Thrombocytopenia; Hospitals; Human immunodeficiency virus; Humans; Immunology; Infections; Infectious diseases; Laboratories; Male; Middle Aged; Neutropenia; Original; Retrospective Studies; Statistics; Studies; Thrombocytopenia; Thrombocytopenia - blood; Thrombocytopenia - epidemiology; Thrombocytopenia - etiology
• ISSN: 0366-6999; 2542-5641
• DOI: 10.4103/0366-6999.151078

Background: The prevalence of thrombocytopenia among Chinese antiretroviral therapy (ART)-naïve HIV-infected adults has not been well-described. The aim of this study was to investigate the prevalence and associated risk factors of thrombocytopenia among Chinese ART-naïve HIV-infected adults. Methods: We performed a cross-sectional study of Chinese adult ART-naïve HIV-infected patients from September 2005 through August 2014. Socio-demographic variables and laboratory results including platelets, CD4+ cell count, and viral load were obtained from medical records. Factors and outcomes associated with thrombocytopenia were assessed using logistic regression. Results: A total of 1730 adult ART-naïve HIV-infected patients was included. The mean age was 38 years. The prevalence of thrombocytopenia was 4.5%. There were significant differences in the prevalence of thrombocytopenia between patients 350 cells/mm 3 (2.8%) compared with patients with CD4+ counts of 50-199 cells/mm 3 (7.1%) (P = 0.002 and P = 0.005, respectively). The prevalence of thrombocytopenia was significantly different by hepatitis C virus antibody (HCV-Ab) seropositivity (10.2% for HCV-Ab positive vs. 3.9% for HCV-Ab negative, P = 0.001). We observed differences in prevalence of thrombocytopenia by mode of transmission of HIV infection: Blood transmission (10.7%) versus men who have sex with men (3.9%) (P = 0.002) and versus heterosexual transmission (3.9%) (P = 0.001). In binary logistic regression analyses, age ≥50 years, HCV-Ab positivity and having a CD4+ cell count of 50-199 cells/mm 3 were significantly associated with thrombocytopenia with adjusted odds ratio of 2.482 (95% confidence interval [CI]: 1.167, 5.281, P = 0.018), 2.091 (95% CI: 1.078, 4.055, P = 0.029) and 2.259 (95% CI: 1.028, 4.962, P = 0.042), respectively. Conclusions: Thrombocytopenia is not common among adult ART-naïve HIV-infected patients in China. Older age (age over 50 years), HCV-Ab positivity and lower CD4+ cell count are associated with an increased risk of thrombocytopenia. Therefore, early diagnosis and treatment of thrombocytopenia in these patients are necessary.