Thrombotic Microangiopathy in Patients with Acquired Immunodeficiency Syndrome Before and During the Era of Introduction of Highly Active Antiretroviral Therapy

The incidence of thrombotic microangiopathy (TMA) was retrospectively evaluated in a cohort of 1223 patients with acquired immunodeficiency syndrome (AIDS) who were observed from January 1985 through December 1996 (before the era of highly active antiretroviral therapy [HAART]), and the incidence wa...

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Bibliographic Details
Published in:Clinical infectious diseases 2002-12, Vol.35 (12), p.1534-1540
Main Authors: Gervasoni, Cristina, Ridolfo, Anna Lisa, Vaccarezza, Mauro, Parravicini, Carlo, Vago, Luca, Adorni, Fulvio, Cappelletti, Anna, Monforte, Antonella d'Arminio, Galli, Massimo
Format: Article
Language:English
Subjects:
Acquired Immunodeficiency Syndrome - complications
Acquired Immunodeficiency Syndrome - drug therapy
Adolescent
Adult
Aged
AIDS
Anti-HIV Agents - adverse effects
Anti-HIV Agents - therapeutic use
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antiretroviral Therapy, Highly Active - adverse effects
Antiviral agents
Biological and medical sciences
Cohort Studies
Cryptosporidiosis
Female
Hemolytic uremic syndrome
Highly active antiretroviral therapy
HIV
HIV/AIDS
Human viral diseases
Humans
Incidence
Infectious diseases
Kaposi sarcoma
Kidneys
Male
Medical sciences
Middle Aged
Peripheral Vascular Diseases - epidemiology
Peripheral Vascular Diseases - etiology
Peripheral Vascular Diseases - pathology
Pharmacology. Drug treatments
Retrospective Studies
Risk Factors
Thrombosis - epidemiology
Thrombosis - etiology
Thrombosis - pathology
Thrombotic microangiopathies
Thrombotic thrombocytopenic purpura
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
Xeroderma pigmentosum
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Summary:The incidence of thrombotic microangiopathy (TMA) was retrospectively evaluated in a cohort of 1223 patients with acquired immunodeficiency syndrome (AIDS) who were observed from January 1985 through December 1996 (before the era of highly active antiretroviral therapy [HAART]), and the incidence was prospectively assessed for 347 patients with AIDS during the period of January 1997 through December 2000 (during the HAART era). Seventeen cases were reported in the former cohort (1.4%). The increased risk of developing TMA was statistically significant in patients with cryptosporidiosis or AIDS-related cancer but not in those with other diseases. In the 1997–2000 cohort, no cases were observed during follow-up. TMA is associated with conditions observed in the advanced phases of human immunodeficiency virus infection. The disappearance of TMA during the HAART era may be explained by the lower percentage of patients with long-lasting CD4+ T cell depletion, advanced AIDS, or cryptosporidiosis or who have undergone multiple courses of chemotherapy for treatment of cancer.
ISSN:1058-4838
1537-6591
DOI:10.1086/344778