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Interferon therapy in intravenous drug users with HIV-associated idiopathic thrombocytopenic purpura
R Stellini1, G Rossi, G Paraninfo
1I Divisione di Malattie Infettive, Spedali Civili di Brescia, Italy.
Background:
There is no generally accepted treatment for human immunodeficiency virus (HIV)--associated idiopathic thrombocytopenic purpura (ITP). recombinant alpha interferon (rIFN) has been used in classic ITP with conflicting results. We have tested its activity in a group of intravenous drug users (IVDUs) with HIV-associated ITP, who also had a high prevalence of chronic liver disease.
Methods:
Nine patients were treated with a short course of rIFN-2b (3 MU s.c. three times a week for four weeks), and their hematological and biochemical parameters were monitored before (t0), at the end (t1), and one month after discontinuation of rIFN therapy (t2).
Results:
Platelet counts increased significantly from 15.9 +/- 7.3 x 10(9)/L at t0 up to 67.0 +/- 38.8 x 10S(9)/L at t1 (p < 0.005), but returned to 24.7 +/- 12.7 x 10(9)/L at t2 (t1 vs t2: p < 0.005). The other parameters did not change, with the exception of the alanine aminotransferase levels, which decreased from 105 IU/L at t0 to 42 IU/L at t1 (p < 0.05).
Conclusions:
A short course of rIFN is an effective treatment for HIV-associated ITP in IVDUs and may also be beneficial for the frequently concomitant chronic liver disease. Since the efficacy of rIFN on the platelet count is short-lived, long-term rIFN administration would be worth testing.