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Zidovudine for Thrombocytopenic Purpura Related to Human Immunodeficiency Virus (HIV) Infection

Eric Oksenhendler, MD; Philippe Bierling, MD; Françoise Ferchal, MD; Jean-Pierre Clauvel, MD; and Maxime Seligmann, MD
[+] Article, Author, and Disclosure Information

Requests for Reprints: Eric Oksenhendler, MD, Service d'lmmunopathologie, Hôpital Saint-Louis, 1 Avenue Claude Vellefaux, 75475 Paris Cedex 10 France.

Current Author Addresses: Drs. Oksenhendler, Clauvel and Seligmann: Department of Immunopathology and INSERM U 108, Hôpital Saint-Louis, Paris, France.

Dr. Bierling: Department of Immunology and Blood Bank, Hôpital Henri Mondor, Créteil, France.

Dr. Ferchal: Department of Virology, Hôpital Saint-Louis, Paris, France.

© 1989 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1989;110(5):365-368. doi:10.7326/0003-4819-110-5-365
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Study Objective: To determine whether zidovudine is effective in increasing the platelet count in patients with thrombocytopenic purpura related to human immunodeficiency virus (HIV) infection.

Design: Nonrandomized controlled trial with two consecutive regimens.

Setting: Immunopathology and hematology clinics at two general hospitals.

Patients: Consecutive sample of 34 patients infected with HIV who had thrombocytopenic purpura (platelets < 50 X 109/L) without visceral bleeding. Twenty-nine patients completed the study; one patient was removed because of drug toxicity.

Interventions: Zidovudine for 12 weeks, 250 mg every 6 hours orally in 10 patients; and 500 mg every 8 hours orally in 24 patients.

Measurements and Main Results: Three of ten patients receiving 250 mg every 6 hours and 12 of 24 patients receiving 500 mg every 8 hours had a persistent increase in their platelet counts. In both groups the mean value of the platelet count increased significantly by week 12; from 28 X 109/L ± 12 (SD) to 57 X 109/L ± 36 in the first group and from 20 X 109/L ± 13 to 77 X 109/L ± 42 in the second group (P < 0.05 and P < 0.01, respectively).

Conclusions: Zidovudine is effective on platelet counts in some patients with HIV-related thrombocytopenia. These results suggest that HIV itself may play a direct or indirect role in the pathogenesis of this disorder.





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