Severe Thrombocytopenia During Dolutegravir-containing Antiretroviral Therapy.

Abstract

A 56-year-old Japanese man diagnosed with acquired immunodeficiency syndrome, Pneumocystis jirovecii pneumonia and cytomegalovirus infection presented with thrombocytopenia after starting antiretroviral therapy, which included dolutegravir (DTG). Although good control of the human immunodeficiency virus and cytomegalovirus infections was achieved, the patient's thrombocytopenia persisted. The patient's platelet count decreased to ≤50,000/μL even after the cessation of valganciclovir, which can cause bone marrow suppression. At five months after starting antiretroviral therapy, DTG was replaced by ritonavir-boosted darunavir. Soon after, his platelet count improved and was maintained at a level of >100,000/μL. This is the first reported case of severe thrombocytopenia during DTG-containing antiretroviral therapy.

• Authors: Kazuhiko Nakaharai, Makiko Miyajima, Hiroaki Kobayashi, Akihiro Shimizu, Yumiko Hosaka, Tetsuya Horino, Seiji Hori
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 56 Issue 16 Pg. 2229-2232 (Aug 15 2017) ISSN: 1349-7235 [Electronic] Japan
• PMID: 28781310 (Publication Type: Case Reports, Journal Article)

Chemical References

• HIV Integrase Inhibitors
• Heterocyclic Compounds, 3-Ring
• Oxazines
• Piperazines
• Pyridones
• dolutegravir

Topics

• Antiretroviral Therapy, Highly Active (adverse effects)
• HIV Infections (drug therapy)
• HIV Integrase Inhibitors (adverse effects, therapeutic use)
• Heterocyclic Compounds, 3-Ring (adverse effects, therapeutic use)
• Humans
• Male
• Middle Aged
• Oxazines
• Piperazines
• Platelet Count
• Pyridones
• Thrombocytopenia (blood, chemically induced)