Haematological features of HIV infection

• Lymphopenia—CD4 lymphopenia may be masked by CD8 lymphocytosis in stage 2; improved by antiviral therapy.

• Neutropenia—marrow suppression by virus or therapy; splenic sequestration.

• Normochromic/normocytic anaemia due to suppression of marrow by virus or therapy. Microangiopathic haemolysis associated with TTP.

• Thrombocytopenia—suppression of marrow by virus or therapy or shortened survival due to immune destruction (may respond to antiviral therapy), infection, TTP or splenic sequestration.

• Bone marrow suppression—direct HIV effect or complication of antiretroviral therapy, ganciclovir, trimethoprim or amphotericin B therapy.

• Bone marrow infiltration—by NHL, Hodgkin's disease, granulomas due to

M. tuberculosis and atypical mycobacteria or disseminated fungal disease. 415

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