A retrospective study of neutropenia in HIV disease

In aiming to define the characteristics of HIV-infected subjects developing neutropenia and describe the causes, features and effects of neutropenia w e undertook a retrospective study in a dedicated HIV unit in London, UK. Tw o hundred and forty-four patients with documented neutropenia, defined as a bsolute neutrophil count (ANC) < 1000/mm(3), during a 12-month period were studied. First neutropenia occurred at a median CD4 count of 30 cells/mm(3) . Low CD4 count was associated with longer episodes of neutropenia with a m ore profound nadir. Two-thirds of episodes lasted less than 2 weeks. ANC na dir was < 500 cells/mm(3) in 45% of episodes. Infections were most frequent in patients with profound but brief neutropenic episodes. Neutropenia was generally mild, short-lived and associated with late-stage disease. However , profound neutropenia did develop suddenly in some patients with no prior history of neutropenia (in 13% first neutropenic ANC recorded was less than or equal to 500 cells/mm(3)), and at CD4 count >200 cells/mm(3). Most pati ents were receiving multiple myelosuppressive therapies. Infection was asso ciated with brief, profound neutropenia.