losartan-potassium and AIDS-Related-Opportunistic-Infections

Human immunodeficiency virus infection causes multilineage hematopoietic defects. Defects in the production and function of CD4+ helper cells have been the focus of the majority of HIV research, but anemia, neutropenia, and thrombocytopenia are significant clinical problems as well. Bone marrow suppression is the dose-limiting toxicity for a number of antiviral and prophylactic medications. Hematopoietic growth factors such as granulocyte colony-stimulating factor or granulocyte-macrophage colony-stimulating factor are used to optimize the delivery of antiretroviral and prophylactic therapy. Because of the expense involved, the most appropriate use of these hematopoietic growth factors remains a subject of intense investigation. This review focuses on recent experimental results.

Topics: AIDS-Related Opportunistic Infections; Bone Marrow Diseases; Erythropoietin; Granulocyte Colony-Stimulating Factor; Hematopoietic Cell Growth Factors; HIV Infections; Humans; Neutropenia; Virus Replication

Topics: AIDS-Related Opportunistic Infections; Anemia; Anemia, Hemolytic, Autoimmune; Antiviral Agents; Bone Marrow Diseases; Erythropoietin; Hematopoietic Cell Growth Factors; HIV Infections; Humans; Neoplasms; Recombinant Proteins

We report the case of a 41-year-old black man with acquired immunodeficiency syndrome who developed a severe chronic anemia due to parvovirus infection. Bone marrow biopsy revealed erythroid aplasia. The infectious nature of the anemia was not recognized, and the patient was treated with erythropoietin. The patient's reticulocyte response was inadequate, however, and he remained anemic. A second bone marrow biopsy showed erythroid hyperplasia and prominent intranuclear parvovirus inclusions within erythroid progenitors. Erythropoietin was discontinued and was followed by a course of intravenous immunoglobulin, which resulted in rapid correction of anemia. To our knowledge, this is the first reported case of fulminant human parvovirus infection exacerbated by erythropoietin administration and documented by sequential bone marrow histologic examination. This case illustrates the critical importance of considering parvovirus in the etiology of chronic anemia with erythroid aplasia in immunocompromised patients.

Topics: Adult; AIDS-Related Opportunistic Infections; Anemia, Aplastic; Antibodies, Viral; Erythrocytes; Erythropoietin; Fatal Outcome; Humans; Hyperplasia; Immunoglobulins, Intravenous; Male; Parvoviridae Infections; Parvovirus B19, Human; Recombinant Proteins; Virus Activation