RESUMO
HIV patients infected through injected drug use have poorer prognosis than other groups. We evaluated the hematological alterations and rates of co-infections in injected drug use patients with AIDS. Injected drug use patients were younger, predominantly of male gender, and presented lower CD4, total lymphocyte, and platelet counts, but not neutrophil count, than control group. Injected drug use patients had a higher rate of hepatitis C and mycobacteria infection. Furthermore, all injected drug use patients with hemoglobin <10.0 g dL-1 and lymphocyte <1000 µL-1 had CD4 count lower than 100 µL-1. In conclusion, HIV-infected injected drug use patients constitute a special group of patients, and hemoglobin concentration and lymphocyte count can be used as surrogate markers for disease severity.
Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Síndrome da Imunodeficiência Adquirida/sangue , Coinfecção/sangue , Abuso de Substâncias por Via Intravenosa/sangue , Síndrome da Imunodeficiência Adquirida/complicações , Estudos Transversais , Diagnóstico Duplo (Psiquiatria) , Progressão da Doença , Estudos Retrospectivos , Índice de Gravidade de Doença , Abuso de Substâncias por Via Intravenosa/complicações , Carga ViralRESUMO
HIV patients infected through injected drug use have poorer prognosis than other groups. We evaluated the hematological alterations and rates of co-infections in injected drug use patients with AIDS. Injected drug use patients were younger, predominantly of male gender, and presented lower CD4, total lymphocyte, and platelet counts, but not neutrophil count, than control group. Injected drug use patients had a higher rate of hepatitis C and mycobacteria infection. Furthermore, all injected drug use patients with hemoglobin <10.0 g dL(-1) and lymphocyte <1000µL(-1) had CD4 count lower than 100µL(-1). In conclusion, HIV-infected injected drug use patients constitute a special group of patients, and hemoglobin concentration and lymphocyte count can be used as surrogate markers for disease severity.
Assuntos
Síndrome da Imunodeficiência Adquirida/sangue , Coinfecção/sangue , Abuso de Substâncias por Via Intravenosa/sangue , Síndrome da Imunodeficiência Adquirida/complicações , Adolescente , Adulto , Idoso , Contagem de Linfócito CD4 , Estudos Transversais , Diagnóstico Duplo (Psiquiatria) , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índice de Gravidade de Doença , Abuso de Substâncias por Via Intravenosa/complicações , Carga Viral , Adulto JovemRESUMO
BACKGROUND: Anemia, neutropenia, and thrombocytopenia are commonly observed in HIV-infected patients. This study was undertaken to evaluate the prevalence of cytopenias and their association with CD4 count. Furthermore, the association of hemoglobin concentration with mortality was also investigated. METHODS: We reviewed the data of 701 HIV-infected patients followed at our institution. Blood cell counts, hemoglobin concentration, CD4 count, and viral load were recorded. We also recorded the mortality rate after 1 year in the groups with CD4 <200/µl and ≥ 200/µl according to hemoglobin concentration. RESULTS: Of the total patients, 37.5% had anemia; 61.1% (110/180) were in the low CD4 group and 29.4% (153/521) were in the high CD4 group (p<0.01). Mean neutrophil counts were 2.610 × 10(9)/l and 3.204 × 10(9)/l in the low CD4 and high CD4 groups, respectively (p<0.01); mean platelet counts were 218.639 × 10(9)/l and 234.807 × 10(9)/l for the low CD4 and the high CD4 groups, respectively (p=0.03). Patients whose hemoglobin concentration was below the median value had a higher death rate in both the low CD4 (14 vs. 4 deaths, p=0.013) and high CD4 (8 vs. 1 death, p=0.0158) groups. CONCLUSIONS: We found an association between CD4 count and hemoglobin level, neutrophil count, and platelet count, and that anemia was independently associated with a higher mortality.
Assuntos
Infecções por HIV/sangue , HIV-1/isolamento & purificação , Doenças Hematológicas/epidemiologia , Adolescente , Adulto , Idoso , Anemia/complicações , Anemia/epidemiologia , Fármacos Anti-HIV/farmacologia , Contagem de Células Sanguíneas , Brasil/epidemiologia , Contagem de Linfócito CD4 , Estudos Transversais , Feminino , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , HIV-1/genética , Doenças Hematológicas/complicações , Hemoglobinas/análise , Hemoglobinas/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Neutropenia/complicações , Neutropenia/epidemiologia , RNA Viral/sangue , Estudos Retrospectivos , Trombocitopenia/complicações , Trombocitopenia/epidemiologia , Carga Viral , Adulto Jovem , Zidovudina/farmacologiaRESUMO
We report a case of a 47-year-old man diagnosed with chronic lymphocytic leukemia (CLL) with two extra copies of chromosome 8. Classical cytogenetic analysis by the immunostimulatory combination of DSP30 and interleukin 2 showed tetrasomy of chromosome 8 in 60% of the metaphase cells (48,XY,+8,+8[12]/46,XY[8]). Spectral karyotype analysis confirmed the abnormality previously seen by G banding. Additionally, interphase fluorescence in situ hybridization using an LSI CEP 8 probe performed on peripheral blood cells without any stimulant agent showed tetrasomy of chromosome 8 in 54% of analyzed cells (108 of 200). To our knowledge, tetrasomy 8 as the sole chromosomal abnormality in CLL has not been previously described. The prognostic significance of tetrasomy 8 in CLL remains to be elucidated. However, the patient has been followed up in the outpatient hospital since 2004 without any therapeutic intervention and has so far remained stable.