Anemia Associated With HIV Disease
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- Anemia is the most common cytopenia in patients with HIV; the prevalence increases as the disease progresses and the CD4 count declines.1
- Mycobacterium avium complex infections are frequently associated with severe anemia. Diagnosis is established on BM examination or culture. Treatment of M. avium complex is described in Chapter 16, Sexually Transmitted Infections, Human Immunodeficiency Virus, and Acquired Immunodeficiency Syndrome.
- Parvovirus B19 should be considered in HIV-infected patients with transfusion-dependent anemia and a low reticulocyte count.
- Laboratory studies: Parvovirus by polymerase chain reaction from serum or BM.
- Treatment with IV immunoglobulin (IVIG) 0.4 g/kg daily for 5–10 days results in erythropoietic recovery. Relapses have occurred between 2 and 6 months and can be successfully managed with maintenance IVIG at a dose of 0.4 g/kg IV every 4 weeks.2