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Effects of 3‐Azidothymidine on Platelet Counts, Indium‐111‐Labelled Platelet Kinetics, and Antiplatelet Antibodies
Author(s) -
Panzer Simon,
Stain Christoph,
Benda Helmut,
Mannhalter Christine
Publication year - 1989
Publication title -
vox sanguinis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.68
H-Index - 83
eISSN - 1423-0410
pISSN - 0042-9007
DOI - 10.1111/j.1423-0410.1989.tb01148.x
Subject(s) - platelet , medicine , zidovudine , antibody , immunology , thrombocytopenic purpura , gastroenterology , platelet transfusion , viral disease , human immunodeficiency virus (hiv)
. Treatment of the acquired immunodeficiency syndrome with 3‐azidothymidine (zidovudine; AZT) can induce severe neutropenia and anemia, while platelet counts increase. In order to understand the mechanism by which this favorable effect on platelets is induced, we prospectively studied platelet kinetics and platelet serology in 8 hemophiliacs receiving the drug. All patients underwent a second investigation after 3 months of treatment. Four patients were thrombocytopenic before treatment. Platelet counts increased significantly already after 1 week of treatment (p = 0.03), when only 3 patients remained thrombocytopenic. In these latter patients a further increase of platelet counts was noticed during the following 3 months. Platelet life‐span was shortened in all patients at the initial investigation and a significant prolongation was measurable at the second evaluation (p = 0.015). Platelet‐associated immunoglobulin G was increased in 3 patients at the first investigation and in 4 patients at the follow‐up. Platelet‐associated complement (PAC3d) was elevated in all subjects at the first determination. It decreased in 6, but increased in 2 patients thereafter; thus these changes did not become significant (p = 0.078). Immunofluorescence studies revealed antiplatelet antibodies in 7 patients' sera before treatment, and in 5 sera during drug therapy. At both investigations, the antibodies bound to the platelet glycoprotein IIIa as was demonstrated by immunoprecipitation of radiolabeled platelet proteins. We conclude, that AZT treatment improves platelet counts in HIV‐infected hemophiliacs primarily by a prolongation of platelet survival without having a significant influence on antiplatelet antibody binding.