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1 November 2004 Supplement

Volume 39, Number S5
Clinical Infectious Diseases 2004;39:S267–S275
© 2004 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2004/3909S5-0005$15.00
DOI: 10.1086/422363
SUPPLEMENT ARTICLE

HIV‐Associated Thrombotic Microangiopathy in the Era of Highly Active Antiretroviral Therapy: An Observational Study

Stephen Becker,1

Gregory Fusco,2

Jennifer Fusco,2

Rukmini Balu,2

Shehnaz Gangjee,2

Clare Brennan,2 and

Judith Feinberg,3 for the

Collaborations in HIV Outcomes Research/US Cohort

1Pacific Horizon Medical Group, San Francisco, California; 2Collaborations in HIV Outcomes Research/US Cohort, GlaxoSmithKline, Research Triangle Park, North Carolina; and 3University of Cincinnati, Cincinnati, Ohio

The prevalence and predisposing factors of thrombotic microangiopathy (TMA) in the era of highly active antiretroviral therapy (HAART) were evaluated among patients in the Collaborations in Human Immunodeficiency Virus (HIV) Outcomes Research/US cohort. Of 6022 patients, 17 (0.3%) had TMA, with unadjusted incidences per 100 person‐years of 0.079 for TMA, 0.009 for thrombotic thrombocytopenic purpura, and 0.069 for hemolytic‐uremic syndrome. Compared with patients without TMA, patients with TMA had lower mean CD4+ cell counts (197 vs. 439 cells/mm3; ) and higher mean log10 HIV‐1 RNA levels (4.6 vs. 3.3 copies/mL; ) at last follow‐up and a significantly greater incidence of acquired immune deficiency syndrome (82.4% vs. 55.3%; ), Mycobacterium avium complex infection (17.6% vs. 3.3%; ), hepatitis C (29.4% vs. 11.3%; ), and death (41.2% vs. 7.4%; ). The prevalence of herpes and use of antiherpetics were slightly higher for patients with TMA, but unadjusted distributions were not statistically significant. TMA in a cohort surveyed after the introduction of HAART was rare and was associated with advanced HIV disease.

Reprints or correspondence: Dr. Stephen L. Becker, Pacific Horizon Medical Group, 2351 Clay St., Ste. 512, San Francisco, CA 94115 ().

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