Increased risk of anemia, neutropenia, and thrombocytopenia in treated HV-infection

796 participants from the Copenhagen Comorbidity in HIV
(COCOMO) study were compared to 2,388 matched controls
from the Copenhagen General Population Study (CGPD) for
the risk cytopenias. Only participants with undetectable viral
load without hepatitis were included. Controls were not tested
for serological markers of hepatitis. Hepatitis is uncommon
in the general Danish population. Untreated HIV-infection is
associated with increased risks of anemia, neutropenia, lymphocytopenia
and thrombocytopenia. The aim of the study was
to evaluate whether these risks remain in successfully treated HIV-infection.
Anemia was defined as mild if hemoglobin was 6.2-8.3 (men), 6.2-7.3 (women),
moderate 4.9-6.1 and severe <4.9 (mmol/L). Neutropenia was defined as: mild 1.0-1.5,
moderate 0.5-0.9, and severe <0.5 (cells/L). Lymphocytopenia as:
mild 0-8-1.0, moderate 0.5-0.79, and severe < 0.5 (cells/L), and
thrombocytopenia as: mild 100-150, moderate 75-99, and severe
<75 (x 109 cells/L). Two different predefined models were
used to adjust the statistical analysis. The first model included
demographic data and the second model included inflammation
related variables. In summary anemia, neutropenia, and
thrombocytopenia were rare but still significantly more common
in the HIV-positive group compared to the controls. Prevalence
was 6.9 % vs 3.4 % (p< 0.001) for anemia, 1.3 % vs 0.2
% (p<0.001) for neutropenia, and 5.5 % vs 2.7 % (p<0.001) for
thrombocytopenia. For lymphocytopenia there was no statistical
difference between the HIV-positive participants and the
controls. A vast majority of the anemia cases were mild and the
same was true for both neutropenia and thrombocytopenia.

Ref; Akdag et al. J Infect Dis. 2019. doi: 10.1093/infdis/jiz394

Comment: The different cytopenias were rare despite the statistically
significant differences between HIV-infected and
controls and were mostly mild. It is unclear what the clinical
significance of these findings is.