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).