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Updated: Jan 26, 2026
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Measuring Deformability and Red Cell Heterogeneity in Blood by Ektacytometry
Published on: January 12, 2018
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Emtricitabine-associated red cell aplasia.
Karen Cohen1, Charle Viljoen2, Christine Njuguna1
1Division of Clinical Pharmacology.
AIDS (London, England)
|April 5, 2019
Summary
Emtricitabine, a drug similar to lamivudine, may cause severe anemia and red cell aplasia in some patients. Stopping the drug often resolves the anemia, indicating a potential cross-reaction.
Area of Science:
- Internal Medicine
- Pharmacology
- Hematology
Background:
- Emtricitabine is a nucleoside reverse transcriptase inhibitor used in antiretroviral therapy.
- Lamivudine, structurally similar to emtricitabine, has been linked to red cell aplasia.
- Severe anemia is a critical adverse event requiring careful monitoring in patients on antiretroviral therapy.
Observation:
- Four patients developed severe anemia shortly after initiating emtricitabine-based antiretroviral therapy.
- Bone marrow biopsies in three patients confirmed the diagnosis of red cell aplasia.
- One patient experienced recurrent anemia upon rechallenge with emtricitabine.
Findings:
- Anemia resolved in three patients after discontinuing emtricitabine.
- One patient died, and another experienced persistent anemia on lamivudine, which resolved upon its withdrawal.
- These cases suggest a potential cross-reactivity between emtricitabine and lamivudine causing red cell aplasia.
Implications:
- Clinicians should consider emtricitabine as a potential cause of red cell aplasia in patients presenting with severe anemia.
- Careful patient selection and monitoring are crucial when prescribing emtricitabine-containing regimens.
- Further investigation into the cross-reactivity between emtricitabine and lamivudine is warranted to optimize HIV treatment strategies.
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