[HIV-related thrombocytopenias].

Thrombocytopenia is a relatively frequent hematological complication in patients infected with the human immunodeficiency virus type 1. Occurring in all risk groups (homosexuals, intravenous drug addicts, hemophiliacs, heterosexuals) this complication has an overall prevalence varying between 5 and 15%. Only a relatively small proportion of patients have severe thrombocytopenia (6 to 24%), and life-endangering bleeding symptoms are not frequent. Accordingly, aggressive treatment is seldom indicated. Corticosteroids should be avoided because they may further compromise the deteriorated immune system of these patients. Splenectomy is efficacious as in patients with non-human immunodeficiency virus related immune thrombocytopenic purpura and infectious complications are not a prominent problem following the operation. Antiretroviral treatment with zidovudine and/or highly active protease inhibitors increases platelet count, but the control of thrombocytopenia is often transient when these drugs are stopped. Other treatments such as alpha-interferon and thrombopoietin require further experiences. On the whole, thrombocytopenia is generally a relatively mild complication of the human immunodeficiency virus infection and aggressive treatment is often unwarranted.