Cytopenic syndrome in HIV-positive patients (anemia, thrombocytopenia, neutropenia, MDS)

Cytopenia is a common hematologic syndrome in people living with human immunodeficiency virus (PLWHIV) infection. However, the prevalence, risk factors for the onset and progression of cytopenic syndrome in patients with HIV infection have not been thoroughly studied. The hemogram may show anemia, thrombocytopenia, neutropenia, lymphocytopenia, or combinations of aforementioned cytopeniasp. In the pathogenesis of cytopenic syndrome, an important role is played by HIV surface envelope glycoproteins, which can contribute to the activation of inflammatory pathways that affect the bone marrow microenvironment. At the same time, cytokines act on hematopoietic stem cells interleukin-6 (IL-6), acts on hepcidin, changing iron homeostasis. Human immunodeficiency virus can reduce the level of endogenous granulocyte colony stimulating factor (G-CSF). Opportunistic infections, especially with those organisms that traditionally lead to granulomatous inflammation, including mycobacteria, fungi, parasites, can lead to myelofibrotic lesions of the bone marrow. Although the prevalence of cytopenias in HIV-infected people has decreased with the introduction of new ART drugs, even fully controlled HIV infection remains a risk factor for anemia, neutropenia, and thrombocytopenia.