{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T23:23:16Z","timestamp":1773616996006,"version":"3.50.1"},"reference-count":35,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T00:00:00Z","timestamp":1726185600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Cytopenias or coagulation deficiencies can occur in people living with HIV (PLWH). The severity of these disorders is influenced by the low levels of CD4+ lymphocytes, viral load, and the stage of viral infection. The aim of our retrospective observational study was to determine the frequency of cytopenias and coagulation deficiencies in PLWH as well as the need for replacement therapy with blood products. We sought to determine whether there is an association between severe anemia or thrombocytopenia (requiring replacement therapy) and CD4+T lymphocyte levels. All 29 patients were critically ill, with 27 out of 29 (93%) in advanced stages of HIV disease and 23 out of 29 (79%) having CD4+ lymphocyte counts below 200 cells\/microL. Most patients were either late presenters (45%) or had been lost to follow-up (41%). In addition to HIV infection, various conditions that could alter hematologic parameters were associated, including co-infections with hepatitis viruses, tuberculosis at various sites, malignant diseases, sepsis, SARS-CoV-2 infection, or other opportunistic infections. No significant correlation was found between severe anemia or severe thrombocytopenia or coagulation deficiencies and the CD4+T lymphocyte count. Our data suggest that these hematological disorders in patients with advanced HIV infection are more likely to be associated comorbidities rather than the HIV infection per se.<\/jats:p>","DOI":"10.3390\/tropicalmed9090213","type":"journal-article","created":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T05:31:44Z","timestamp":1726205504000},"page":"213","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Replacement Therapy with Blood Products in People Living with HIV"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3442-2338","authenticated-orcid":false,"given":"Mihaela Cristina","family":"Olariu","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"\u201cMatei Bals\u201d National Institute of Infectious Diseases, 021105 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2881-878X","authenticated-orcid":false,"given":"Mihaela Adela","family":"Iancu","sequence":"additional","affiliation":[{"name":"Department of Internal, Family and Occupational Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihai Hristu","family":"Olariu","sequence":"additional","affiliation":[{"name":"\u201cMatei Bals\u201d National Institute of Infectious Diseases, 021105 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Aram\u0103","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"\u201cMatei Bals\u201d National Institute of Infectious Diseases, 021105 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u0103d\u0103lina","family":"Simoiu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"\u201cMatei Bals\u201d National Institute of Infectious Diseases, 021105 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miruna Maria","family":"Cruceru","sequence":"additional","affiliation":[{"name":"\u201cMatei Bals\u201d National Institute of Infectious Diseases, 021105 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9560-6264","authenticated-orcid":false,"given":"Ecaterina Constanta","family":"Barbu","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Balanescu","sequence":"additional","affiliation":[{"name":"Department of Internal, Family and Occupational Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Romania Clinical Research Unit RECIF (Reseau d\u2019Epidemiologie Clinique International Francophone), 020125 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihai","family":"Lazar","sequence":"additional","affiliation":[{"name":"\u201cMatei Bals\u201d National Institute of Infectious Diseases, 021105 Bucharest, Romania"},{"name":"Department of Pathophysiology, Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"253","DOI":"10.5045\/kjh.2011.46.4.253","article-title":"Hematological manifestations of human immunodeficiency virus infection and the effect of highly active anti-retroviral therapy on cytopenia","volume":"46","author":"Choi","year":"2011","journal-title":"Korean J. Hematol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Kyeyune, R., Saathoff, E., Ezeamama, A., L\u00f6scher, T., Fawzi, W., and Guwatudde, D. (2014). Prevalence and correlates of cytopenias in HIV-infected adults initiating highly active antiretroviral therapy in Uganda. BMC Infect. Dis., 14.","DOI":"10.1186\/1471-2334-14-496"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.1086\/383031","article-title":"Anemia in HIV infection: Clinical impact and evidence-based management strategies","volume":"38","author":"Volberding","year":"2004","journal-title":"Clin. Infect. Dis."},{"key":"ref_4","first-page":"160","article-title":"Afectarea m\u0103duvei hematogene la pacien\u021bii cu infec\u021bie HIV","volume":"13","author":"Olariu","year":"2018","journal-title":"Rom. J. Med. Pract."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1093\/inthealth\/ihaa036","article-title":"Anemia and thrombocytopenia in people living with HIV\/AIDS: A narrative literature review","volume":"13","author":"Marchionatti","year":"2021","journal-title":"Int. Health"},{"key":"ref_6","unstructured":"Ortel, T., and Federman, D. (2019, January 7\u201310). Street Drugs: Emerging Hematologic Complications of Illicit Drug Us. Proceedings of the 61st ASH Annual Meeting, Orlando, FL, USA."},{"key":"ref_7","unstructured":"World Health Organization (2024, September 02). WHO Case Definitions of HIV for Surveillance and Revised Clinical Staging and Immunological Classification of HIV-Related Disease in Adults and Children. ISBN: 9789241595629. Available online: https:\/\/iris.who.int\/handle\/10665\/43699."},{"key":"ref_8","unstructured":"World Health Organization (2024, July 15). Worldwide Prevalence of Anaemia 1993\u20132005. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789241596657."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1513\/AnnalsATS.202109-1078OC","article-title":"Red Blood Cell Transfusion at a Hemoglobin Threshold of 7 g\/dl in Critically Ill Patients: A Regression Discontinuity Study","volume":"19","author":"Bosch","year":"2022","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"45","DOI":"10.12703\/P6-45","article-title":"Management of thrombocytopenia","volume":"6","author":"Izak","year":"2014","journal-title":"F1000Prime Rep."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1378\/chest.13-0121","article-title":"Thrombocytopenia in critically ill patients receiving thromboprophylaxis: Frequency, risk factors, and outcomes","volume":"144","author":"Williamson","year":"2013","journal-title":"Chest"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1056\/NEJMra010501","article-title":"Immune thrombocytopenic purpura","volume":"346","author":"Cines","year":"2002","journal-title":"N. Engl. J. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1111\/j.1468-1293.2010.00857.x","article-title":"Late presentation of HIV infection: A consensus definition","volume":"12","author":"Antinori","year":"2011","journal-title":"HIV Med."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Mocroft, A., Lundgren, J.D., Sabin, M.L., Monforte, A.D., Brockmeyer, N., Casabona, J., Castagna, A., Costagliola, D., Dabis, F., and De Wit, S. (2013). Risk factors and outcomes for late presentation for HIV-positive persons in Europe: Results from the collaboration of observational HIV epidemiological research Europe study (COHERE). PLoS Med., 10.","DOI":"10.1371\/journal.pmed.1001510"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1111\/j.1468-1293.2004.00193.x","article-title":"The high cost of medical care for patients who present late (CD4 < 200 cells\/\u03bcL) with HIV infection","volume":"5","author":"Krentz","year":"2004","journal-title":"HIV Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1007\/s11481-011-9292-5","article-title":"Opioid Drug Abuse and Modulation of Immune Function: Consequences in the Susceptibility to Opportunistic Infections","volume":"6","author":"Roy","year":"2011","journal-title":"J. Neuroimmune Pharmacol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2717","DOI":"10.1111\/bph.13750","article-title":"Opioids and the Immune System\u2013Friend or Foe","volume":"175","author":"Plein","year":"2017","journal-title":"Br. J. Pharmacol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1097\/00002030-199403000-00007","article-title":"Continued Drug Use and Other Cofactors for Progression to AIDS among Injecting Drug Users","volume":"8","author":"Ronald","year":"1994","journal-title":"AIDS"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1093\/aje\/kwj059","article-title":"Illicit Drug Use and HIV-1 Disease Progression: A Longitudinal Study in the Era of Highly Active Antiretroviral Therapy","volume":"163","author":"Lucas","year":"2006","journal-title":"Am. J. Epidemiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1007\/s10461-017-1842-2","article-title":"Prescription Opioid Use is Associated with Virologic Failure in People Living with HIV","volume":"22","author":"Flores","year":"2018","journal-title":"AIDS Behav."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Basukala, B., Rossi, S., Bendiks, S., Gnatienko, N., Patts, G., Krupitsky, E., Lioznov, D., So-Armah, K., Sagar, M., and Cheng, C. (2023). Virally Suppressed People Living with HIV Who Use Opioids Have Diminished Latency Reversal. Viruses, 15.","DOI":"10.3390\/v15020415"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1001\/jama.300.5.550","article-title":"Highly active antiretroviral therapy and survival in HIV-infected injection drug users","volume":"300","author":"Wood","year":"2008","journal-title":"JAMA"},{"key":"ref_23","first-page":"165","article-title":"HIV-1 infection and hematologic picture","volume":"14","author":"Re","year":"1991","journal-title":"Microbiologica"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"91","DOI":"10.5501\/wjv.v2.i2.91","article-title":"Effects of human immunodeficiency virus on the erythrocyte and megakaryocyte lineages","volume":"2","author":"Gibellini","year":"2013","journal-title":"World J. Virol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Assefa, M., Abegaz, W.E., Shewamare, A., Medhin, G., and Belay, M. (2015). Prevalence and correlates of anemia among HIV infected patients on highly active anti-retroviral therapy at Zewditu Memorial Hospital, Ethiopia. BMC Hematol., 15.","DOI":"10.1186\/s12878-015-0024-6"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Gedefaw, L., Yemane, T., Sahlemariam, Z., and Yilma, D. (2013). Anemia and risk factors in HAART na\u00efve and HAART experienced HIV positive persons in south west Ethiopia: A comparative study. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0072202"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"455","DOI":"10.2147\/HIV.S280338","article-title":"Predictors of Anemia among Adult HIV Positive Patients on First-Line Antiretroviral Therapy in Northwest Ethiopia: A Retrospective Follow-Up Study","volume":"13","author":"Agegnehu","year":"2021","journal-title":"HIV\/AIDS-Res. Palliat. Care"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1111\/bjh.13783","article-title":"Haematological manifestations of human immune deficiency virus infection","volume":"171","author":"Vishnu","year":"2015","journal-title":"Br. J. Haematol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Assinger, A. (2014). Platelets and infection\u2014An emerging role of platelets in viral infection. Front. Immunol., 5.","DOI":"10.3389\/fimmu.2014.00649"},{"key":"ref_30","first-page":"381","article-title":"Thrombocytopenia in chronic hepatitis C","volume":"19","author":"Olariu","year":"2010","journal-title":"J. Gastrointestin. Liver Dis."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Chelariu, A.-C., Coman, A.E., Lionte, C., Gorciac, V., Sorodoc, V., Haliga, R.E., Petris, O.R., Bologa, C., Puha, G., and Stoica, A. (2022). The Value of Early and Follow-Up Elevated Scores Based on Peripheral Complete Blood Cell Count for Predicting Adverse Outcomes in COVID-19 Patients. J. Pers. Med., 12.","DOI":"10.3390\/jpm12122037"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Mana\u00e7as, L.R.A., de Amorim, R.L.O., Aguila, A., Novo, P.C., and Badin, R.C. (2024). Evaluation of hematological changes and immune response biomarkers as a prognostic factor in critical patients with COVID-19. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0297490"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1468-1293.2012.01027.x","article-title":"Endothelial dysfunction, increased inflammation, and activated coagulation in HIV-infected patients improve after initiation of highly active antiretroviral therapy","volume":"14","author":"Arildsen","year":"2013","journal-title":"HIV Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"ofz303","DOI":"10.1093\/ofid\/ofz303","article-title":"Good Fences Make Good Neighbors: Human Immunodeficiency Virus and Vascular Disease","volume":"6","author":"Mayne","year":"2019","journal-title":"Open Forum Infect. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1161\/ATVBAHA.122.318232","article-title":"Cardiovascular Disease and Thrombosis in HIV Infection","volume":"43","author":"Perkins","year":"2023","journal-title":"Arter. Thromb. Vasc. Biol."}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/9\/9\/213\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:55:28Z","timestamp":1760111728000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/9\/9\/213"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,13]]},"references-count":35,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["tropicalmed9090213"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed9090213","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,13]]}}}