1887

Abstract

Anaemia is frequent in patients with human immunodeficiency virus infection, and antiretroviral drugs have been implicated. Whilst therapy-induced anaemia is more readily attributed to zidovudine, lamivudine-associated, potentially life-threatening, pure red cell aplasia (PRCA) has been less recognized in the past and is only infrequently documented in the literature. We report on a patient suffering from what turned out to be lamivudine-induced PRCA who required 15 units of blood within 3 weeks before recovering swiftly following lamivudine (3TC) treatment withdrawal. As reviewed here, the nature of this condition is not well described in general, the onset appears to be variable and occurs at any CD4 count, but rapid improvement after cessation of drug administration appears to be a consistent feature.

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2008-08-01
2024-12-04
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References

  1. Claster S. 2002; Biology of anemia, differential diagnosis, and treatment options in human immunodeficiency virus infection. J Infect Dis 185:Suppl 2S105–S109 [CrossRef]
    [Google Scholar]
  2. Costello C. 1989; Haematology in HIV Disease. In Postgraduate Haematology . , 3rd edn, chapter. 23 pp 380–393 Edited by Hoffbrand A. F., Lewis S. M. Oxford: Heinemann;
  3. Dornsife R. E., Averett D. R. 1996; In vitro potency of inhibition by antiviral drugs of hematopoeitic progenitor colony formation correlates with exposure at hemotoxic levels in human immunodeficiency virus-positive humans. Antimicrob Agents Chemother 40:514–519
    [Google Scholar]
  4. Fangman J. J., Scanden D. T. 2005; Anemia in HIV infected adults: epidemiology, pathogenesis and clinical management. Curr Hematol Rep 4:95–102
    [Google Scholar]
  5. Forna F., Liechty C. C., Solberg P., Asiimwe F., Were W., Mermin J., Behumbiize P., Tong T., Brooks J. T., Weidle P. J. 2007; Clinical toxicity of highly active antiretroviral therapy in a home based AIDS care programme in rural Uganda. J Acquir Immune Defic Syndr 44:456–462 [CrossRef]
    [Google Scholar]
  6. Hassan F. 2006; Taking stock of the national ARV programme: what exactly have we done?. South Afr J HIV Medicine 23:32–34
    [Google Scholar]
  7. Hester E. K., Peacock J. E. Jr 1998; Profound and unanticipated anemia with lamivudine-zidovudine combination therapy in zidovudine-experienced patients with HIV infection. AIDS 12:439–440
    [Google Scholar]
  8. Khawcharoenporn T., Shikuma C. M., Williams A. E., Chow D. C. 2007; Lamivudine associated macrocytosis in HIV infected patients. Int J STD AIDS 18:39–40 [CrossRef]
    [Google Scholar]
  9. Kumarasamy N., Vallabhaneni S., Cecelia A. J., Yepthomi T., Balakrishnan P., Saghayam S., Flanigan T. P., Carpenter C. C., Solomon S., Mayer K. H. 2007; Reasons for modification of generic highly active antiretroviral therapeutic regimens among patients in southern India. J Acquir Immune Defic Syndr 46:119–121 [CrossRef]
    [Google Scholar]
  10. Majluf-Cruz A., Luna-Castanos G., Trevino-Perez S., Santoscoy M., Nieto-Cisneros L. 2000; Lamivudine-induced pure red cell aplasia. Am J Hematol 65:189–191 [CrossRef]
    [Google Scholar]
  11. Moh R., Danel C., Sorho S., Sauvageot D., Anzian A., Minga A., Gomis O. B., Konga C., Inwoley A. other authors 2005; Haematological changes in adults receiving a zidovudine-containing HAART regimen in combination with cotrimoxazole in Cote d'Ivoire. Antivir Ther 10:615–624
    [Google Scholar]
  12. Morris D. J. 1994; Adverse effects and drug interactions of clinical importance with antiviral drugs. Drug Saf 10:281–291 [CrossRef]
    [Google Scholar]
  13. Nuesch R., Srasuebkul P., Ananworanich J., Ruxrungthan K., Phanuphak P., Duncombe C. 2006; Monitoring toxicity of antiretroviral therapy in resource limited settings: a prospective clinical trial cohort in Thailand. J Antimicrob Chemother 58:637–644 [CrossRef]
    [Google Scholar]
  14. Sloand E. 2005; Hematologic complications of HIV infection. AIDS Rev 7:187–196
    [Google Scholar]
  15. Tseng A., Conly J., Fetcher D., Keystone D., Salit I., Walsley S. 1998; Precipitous declines in hemoglobin levels associated with combination zidovudine and lamivudine therapy. Clin Infect Dis 27:908–909 [CrossRef]
    [Google Scholar]
  16. Walker R. E., Parker R. I., Kovacs J. A., Masur H., Lane H. C., Carleton S., Kirk L. E., Gralnick H. R., Fauci A. S. 1988; Anemia and erythropoiesis in patients with the acquired immunodeficiency syndrome (AIDS) and Kaposi sarcoma treated with zidovudine. Ann Intern Med 108:372–376 [CrossRef]
    [Google Scholar]
  17. Weitzel T., Plettenberg A., Albrecht D., Lorenzen T., Stoehr A. 1999; Severe anemia as a newly recognized side effect caused by lamivudine. AIDS 13:2309–2311 [CrossRef]
    [Google Scholar]
  18. Young N. S., Brown K. E. 2004; Parvovirus B19. N Engl J Med 350:586–597 [CrossRef]
    [Google Scholar]
  19. Zon L. I., Arkin C., Groopman J. E. 1988; Hematologic manifestations of the human immunodeficiency virus (HIV). Semin Hematol 25:208–219
    [Google Scholar]
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