A Retrospective Study Of Clinical Features With 45 HIV/AIDS-related Thrombocytopenia Patients

Objective:A retrospective study to analyze clinical datas of patients with HIV/AIDS-related Thrombocytopenia,investigating the clinical characteristics,therapeutic effect and possible influencing factors of HIV/AIDS-related Thrombocytopenia patients,and to provide real-world data for the diagnosis and treatment for HIV/AIDS-related Thrombocytopenia,and provide a basis for prospective research.Methods:A retrospective analysis was performed on the cases datas of 45 HIV/AIDS-related Thrombocytopenia patients admitted in the affiliated infectious disease hospital of Kunming Medical University from 2010 to 2018.And then analyze relevant datas of the clinical signs and symptoms of those patients,auxiliary examinations and laboratory inspections and so on.Then summarize the clinical characteristics,evaluate the therapeutic effect and explore the possible factors affecting the therapeutic with statistical analysisof HIV/AIDS-related Thrombocytopenia of those patients.Results:Among the 45 HIV/AIDS-related Thrombocytopenia,31 Of them with AIDS and 14 were in the asymptomatic stage of HIV infection.The median age of onset was 43 years,and patients aged 15-40 years were the most.There were more males than females,with a male-to-female ratio of 1.37 to 1.Among them,most patients(33)took bleeding as the primary manifestation,while the most common bleeding site was the cutaneous mucosal.Among the 45 HIV/AIDS-related Thrombocytopenia patients,accounting for 88.9%(40/45)when the number was less than or equal to 30*109/L,twenty(20/45)HIV/AIDS-related Thrombocytopenia patients were combined with other hematological abnormalities at the same time,including 11(24.4%)patients with anemia alone,4(8.9%)patients with leukopenia,2(4.4%)patients with leukopenia alone,and 3 patients(6.7%)with anemia and leukopenia.Also the anaemia is mild anaemia more.There was no difference in CD4+T lymphocyte count between HIV/AIDS-related Thrombocytopenia patients with other hematological abnormalities and those without other hematological abnormalities(P=0.129).In the evaluation of bleeding score,Spearman correlation analysis found that the level of bleeding score was no correlation with CD4+T lymphocyte counts and platelet counts,but it may be negatively correlated with CD4+T lymphocyte counts and platelet counts by scatter plot.Among the 45 HIV/AIDS-related Thrombocytopenia patients,the platelet count increased in 7 patients after HAART only,and the remaining 38 patients were treated with ITP-related therapies such as glucocorticoids,TPO-R agents and immunoglobulins.Among them,1 newly diagnosed HIV/AIDS-related Thrombocytopenia was excluded from the efficacy evaluation due to no re-examination of blood routine after drug use,and the remaining 37 patients were involved in the overall efficacy analysis and evaluation upon discharge.Four patients(10.8%)were found to have achieved complete response(CR),and all were in the high-dose hormone shock therapy group,sixteen patients(43.2%)achieved response(R),17 patients(45.9%)had no response(NR),and the total effective rate was 54.1%.Among them,the total effective rate at the standard dose hormone group was 42.1%,73.3%in the high-dose hormone group,and 33.3%in the multi-drug combination group.The total effective rates of newly diagnosed HIV/AIDS with thrombocytopenia,persistent HIV/AIDS with thrombocytopenia and chronic HIV/AIDS with thrombocytopenia were 68.4%,42.9%and 36.4%,respectively.Univariate analysis found that only age and HIV infection pathway(P=0.033,P=0.006)may affect the efficacy,and multivariate analysis found only age may affect the efficacy(P=0.029).Conclusions:1.HIV/AIDS-related Thrombocytopenia patients who like HIV patients are more likely to occur in the 15-40 age group,and males are more than females(It should be related to the cause of HIV infection).In clinical practise,bleeding at superficial sites such as skin mucosal is the primary clinical manifestation..2.The clinical manifestations of HIV/AIDS-related thrombocytopenia are often inconsistent with the platelet count,and bleeding score may be negatively correlated with CD4+T lymphocyte count and initial platelet count.3.In the clinical treatment of HIV/AIDS-related thrombocytopenia,single HAART can be considered.If HAART fails to alleviate thrombocytopenia,reference should be made to plus the individualized selection of treatment options for immune thrombocytopenia on the basis of antiviral therapy.And this research suggests that Among them the high-dose dexamethasone therapy is better,but usually need 1 time of consolidation therapy after half a month.And patients with different routes of infection may need individualized treatment.