TITLE:
Progression of Platelet Counts in Treatment Naïve HIV/HCV Co-Infection
AUTHORS:
Jonathan E. Schelfhout, Danijela A. Stojanovic, Amy Houtchens, Heidi M. Crane, Edward R. Cachay, Elizabeth R. Brown, Sonia M. Napravnik, Mari M. Kitahata, Michael S. Saag, Peter W. Hunt, Teresa L. Kauf, Joseph A. C. Delaney
KEYWORDS:
HCV; HIV; AIDS; Co-Infection; Platelet Count; Thrombocytopenia
JOURNAL NAME:
World Journal of AIDS,
Vol.3 No.1,
March
29,
2013
ABSTRACT: Background: Previous research has suggested an association between infection with hepatitis
C virus (HCV) or with human immunodeficiency virus (HIV) and low platelet
counts. This study
estimates platelet count changes over time in HIV/HCV co-infected participants
and compares them with the changes in platelet count among HIV mono-infected
participants to test if HIV/HCV co-infection is associated with lower platelet
counts. Methods: This retrospective cohort study included all HIV
treatment naive patients from four sites in the Centers for AIDS Research
Network of Integrated Clinical Systems (CNICS) cohort with platelet count
measurements between 2002 and 2009. We conducted a mixed effects linear
regression modeling the mean change in platelet count per year while adjusting
for age, sex, race, baseline CD4 cell count, and site. Index date was the first
platelet count after 2002, and participants were censored upon initiation of
treatment for HIV or HCV. Results: There were 929 HIV/HCV co-infected and 3558 HIV mono-infected participants with
a mean follow-up time of 1.2 years. HIV/HCV co-infected participants had on
average a slighter lower platelet count at baseline (234,040 vs. 242,780/μL;
p-value = 0.004), and a more rapid mean
reduction per year (7230 vs. 3580/μL; p-value 0.001) after adjusting for age, sex,
baseline CD4 count. Conclusions: In
treatment naive participants, HIV/HCV co-infection is associated with a more
rapid decline in platelet count compared with HIV mono-infection.