Hematologic abnormalities among HIV-infected patients - Associations of significance for dentistry

Objective. The purpose of this study was to determine the prevalence and se verity of and the factors associated with peripheral blood cytopenias among HIV-infected patients. Study design. The investigation involved 516 HIV-infected adults in a longi tudinal study of oral disease. Prevalence of hemoglobin, hematocrit, white blood cell, neutrophil, lymphocyte, and platelet values below the lower lim it of normal and certain hematologic "critical values" were derermined. Dem ographic, clinical/immunologic/viral stage, medications, and oral lesions w ere assessed for association with cytopenias by chi(2) and bivariate analys es. Results. Findings with respect to prevalence were as follows: anemia, 51%; leukopenia, 43.4%; neutropenia, 27.5%; lymphopenia, 20.7%; thrombocytopenia , 15.5% Severe cytopenias were detected in fewer than 1% of the patients. S everity of HIV clinical disease and CD4 cell count depletion were significa ntly associated with all cytopenias. High viral load was associated only wi th the leukopenias. Black race, antiparasitic therapy, and some oral lesion s were associated with certain cytopenias. Conclusions. In HIV-infected patients, mild cytopenias are common; however, severe anemia, neutropenia, and thrombocytopenia that may predispose to ce rtain oral manifestations and dental surgical complications are rare.