Neutropenia in Human Immunodeficiency Virus Infection
Journal - Archives of Internal Medicine
Methods: The prevalence of neutropenia among 1729 HIV-infectedwomen, followed up as part of the Women's Interagency HIV Study,was evaluated. The CD4 lymphocyte counts, HIV-1 RNA levels,and complete blood cell counts, including absolute neutrophilcounts, were obtained at 6-month intervals.Results: Neutropenia was common among HIV-infected women;at baseline, 44% had neutrophil counts less than 2000/µL,whereas 7% had counts less than 1000/µL. During 7.5 yearsof follow-up, neutrophil counts less than 2000/µL occurredon at least 1 occasion in 79%, whereas absolute neutrophil countsless than 1000/µL were documented in 31%. Worsening HIVdisease parameters, such as lower CD4 cell counts (P<.001)and higher HIV-1 RNA levels (P<.001), were associated withdevelopment of neutropenia. Resolution of neutropenia was associatedwith higher CD4 cell counts (P<.001) and use of HAART (P=.007).We found that HAART, without zidovudine, was associated withprotection against development of neutropenia. On multivariateanalysis, neutropenia was not found to be associated with decreasedsurvival among HIV-infected women.Conclusions: Worsening HIV disease parameters are associatedwith neutropenia in HIV-infected women. Treatment with HAART,without zidovudine in the regimen, protects against developmentof neutropenia, whereas HAART use and higher CD4 cell countsare associated with resolution of neutropenia. Neutropenia isnot associated with decreased survival in HIV-infected women.