Aquino MZ, Sato HK, Kamikawa J, Marques HH, Gusmao Filho FA, Valente MT, Sakane PT, Okay Y; International Conference on AIDS.
Int Conf AIDS. 1996 Jul 7-12; 11: 105 (abstract no. Mo.B.1293).
Depto of Pediatrics Universidade de Sao Paulo, Sao Paulo, Brazil. Fax: 55-11 30665703.
Objective: To describe the occurrence and management of thrombocytopenia in HIV-infected children.Methods: Two hundred and five children with AIDS have been followed since June 1985. Twenty developed thrombocytopenia (less than 50.000cells/mm).Nineteen were vertically infected and one infected by blood products. Subjects were followed a median of 28,9 mo (range 7d-83mo). Sixty-five percent were classified as B, 30% as C and 5% as A (CDC Classification) at the diagnosis of AIDS. The follow up was done with CBC and clinical observation, monthly. Results: Because of the lack of IVIG during the first 7 years in our institution, it was possible to observe two different groups of children. The first one (G1) with 10 children had not received IVIG and the second (G2) received IVIG (2g/kg-5d and 0,4g/kg/mo) when the disorder occurs. Both groups were similar about the time of follow up, age and antiretroviral therapy used before the thrombocytopenia. G1 and G2 were similar too in the number of children in which the throbocytopenia was the first manifestation of the disease (4 ch. each). In G1 we observed 50% spontaneous remission. In this group occurred 4 (40%) deaths closely related to bleeding and thrombocytopenia. In G2, the recovery after IVIG occurred in 8 children (80%). Nobody died because of severe bleeding. The statistic analysis showed no significance in the use of IVIG as a treatment for thrombocytopenia, compared to spontaneous remission (Fisher exact, 2 tailed, P-value=0,3498). However, the same test, to compare the prevention of death due to bleeding related to thrombocytopenia, with the use of IVIG, was relevant (Fisher exact, 2 tailed, P-value=0,0866). The small number of subjects in this study is insufficient to affirm any other relationship. Conclusion: The management of HIV associated thrombocytopenia is very difficult and the pathophysiology is not well understood. This study aims to contribute to the discussion about IVIG therapy showing its relevance in the prevention of death related to severe bleeding.
Publication Types:
Keywords:
- AIDS Vaccines
- Acquired Immunodeficiency Syndrome
- Child
- Drug Therapy, Combination
- HIV Infections
- HIV Seropositivity
- Humans
- Immunoglobulins, Intravenous
- Thrombocytopenia
- drug therapy
- therapy
Other ID:
UI: 102217256
From Meeting Abstracts