EFFECT OF SPLENECTOMY ON HIV-RELATED THROMBOCYTOPENIA AND PROGRESSIONOF HIV-INFECTION IN PATIENTS WITH SEVERE HEMOPHILIA

Between May 1983 and September 1991 eleven patients with severe haemop hilia underwent splenectomy for HIV-related thrombocytopenia. The sust ained complete remission rate (platelets > 100 x 10(9)/l) was 82 % ove r a mean follow-up period of 54 months. This group was compared with 2 2 age-matched non-thrombocytopenic HIV seropositive haemophiliacs who had not undergone splenectomy. Both groups had equivalent use of facto r concentrate and there was no significant difference between the grou ps in terms of anti-retroviral treatment. Analysis of clinical progres sion of HIV infection and CD4 positive lymphocyte (CD4+) counts, for t he time since splenectomy, revealed no significant difference in progr ession of HIV infection in the splenectomized group compared with the control group. It is concluded that splenectomy is an effective treatm ent for HIV-related thrombocytopenia and has no adverse effect on the progression of HIV infection.