Bone marrow study is frequently performed in patients with HIV presenting with cytopenia. The aim is to find the etiology of cytopenia such as opportunistic infection, malignancy or drug-related. We conducted retrospective study to determine whether using hematocrit, white blood cell count, percentage of neurotrophil and platelet count can predict the etiology of cytopenia in HIV-infected patients.
We performed retrospective chart review of bone marrow study and complete blood count in HIV patients done in Udon Thani hospital from 2011 to 2014.We divided patients into 3 groups according to etiology: 1) Opportunistic infection or malignancy 2) Drug-induced cytopenia 3) No etiology found
There were 83 bone marrow studies performed. Means and standard deviations of hematocrit, total white blood count, percentage of neutrophil and platelet count were shown in table. Patients with drug-induced cytopenia (group 2) had significantly lower platelet, total white blood cell count and percentage of neutrophil compared to patients with opportunistic infection or malignancy (group 1) and patient without etiology (group 3) (p = 0.006, 0.044, 0.001 for each hematologic parameter respectively in group 2 vs. group 1 and p =0.018, 0.026, 0.001 for each hematologic parameter respectively in group 2 vs. group 3).
Patient with opportunistic infection or malignancy (group 1) had significantly lower platelet count compare to patient without etiology (group 3) (mean 118,433 vs 230,930 cell/mm3 p=0.046), while there was no significant difference in other hematologic parameter.
From this study, HIV patients who developed cytopenia from drug tend to have lower hematocrit and neutrophil count, while the patients with opportunistic infection or malignancy causing cytopenia tend to have lower platelet count. This finding may support physician in the management of HIV patients. In patients who is on antiretroviral agents especially zidovudine (AZT), bone marrow study may not help elicit etiology.
E. Thiansukhon, None