Analysis of clinical manifestations and risk factors of HIV-1 associated thrombocytopenia in a general teaching hospital in western China

Abstract

BackgroundThrombocytopenia is one of the hematologic disorders that frequently accompany HIV-1 infection. The interaction of HIV-1 and platelets is crucial in the Blood-Brain Barriers (BBB) degeneration and causes neuroinflammation. The research aims to evaluate the prevalence and risk factors for HAT (HIV-1 associated thrombocytopenia) and summary the features of HAT-related neuroinflammation. MethodA retrospective study including 221 HAT patients was conducted in West China Hospital from 2017 to 2021. Clinical and laboratory data was analyzed the prevalence and risk factors for HAT and HAT-related neuroinflammation. ResultsThe prevalence of HAT was 11.06% and most patients were men (76.92%), elderly ([≥]50, 55.21%) and 63.80% patients were mild thrombocytopenia. CD4+ T cell count, platelet crit (PCT) and the rate of large platelets (P-LCR) were significantly different between HAT group and control group (P < 0.001, P 0.001, P=0.002). CD4+ T cell count <200 cell/L (P=0.001) was an important risk factor in the occurrence of HAT while advanced age and high viral load were closely related to the occurrence of HAT. HAT-related neuroinflammation patients were mostly distributed in male (X2=10.066, P=0.007), with higher viral load (X2=12.297, P=0.006) and advanced age (X2=11.721, P=0.02) with neuropsychiatric symptoms and rising level of inflammatory factors like IL-6 and proteins in CSF. ConclusionHAT and HAT with neuroinflammation cannot be ignored in HIV-1 infection because of the activation of monocytes, macrophages and microglia, further causing thrombocytopenia and neuroinflammation. Advanced age, lower CD4+ T cell count and high viral load were closely related to the occurrence of HAT and HAT-related neuroinflammation.