INCREASE OF HEMOGLOBIN-A2 IN HUMAN IMMUNODEFICIENCY VIRUS-1-INFECTED PATIENTS TREATED WITH ZIDOVUDINE

We observed increased hemoglobin A2 (HbA2) levels in an asymptomatic h uman immunodeficiency virus-1 (HIV1) patient with no previous history of beta-thalassemia. He was treated only with zidovudine (AZT). In an attempt to understand this observation, a retrospective study was init iated to determine whether mean HbA2 levels are higher in AZT-treated patients than in subjects not receiving this drug and to assess if oth er hematologic alterations are associated with elevated HbA2. One hund red fifty-one HIV-positive cases were investigated; AZT was administer ed to 81 of them. The mean value of HbA2 was 0.032 (SD +/- 0.005) for the treated group vs. 0.027 (SD +/- 0.004) for the controls. This diff erence was highly significant (P < 0.001). Twenty-four patients (31%) in the treated group had elevated HbA2 levels vs. none in the controls . Bone marrow toxicity seemed to be more significant in patients with heightened HbA2 Values, and HbA2 levels did not increase with CDC clin ical stage. We conclude that AZT may be linked to high HbA2 levels in some patients.