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Consider This in Patients with TMA—and Vice Versa

J Clin Apher; ePub 2018 Jan 26; Bade, Giffi, et al

HIV should be considered in people with of thrombotic microangiopathy (TMA), and vice versa, researchers concluded after conducting a study involving 102 individuals. Participants underwent therapeutic plasma exchange (TPE) for TMA between 2000 and 2012. Investigators compared results in patients known to be HIV-positive with those who were HIV-negative. Among the results:

  • 27% of patients were HIV-positive.
  • They had a median viral load of 89,500 copies/mL and median CD4 count of 58 cells/µL.
  • 61% of HIV-positive patients had concurrent infections, vs 24% of HIV-negative individuals.
  • A higher proportion of HIV-positive patients had platelet counts <10,000/mcL.
  • Number of TPE procedures to reach remission, remission rate, mortality, and relapse rate were similar in both groups.


Bade N, Giffi V, Baer M, Zimrin A, Law J. Thrombotic microangiopathy in the setting of human immunodeficiency virus infection: High incidence of severe thrombocytopenia. [Published online ahead of print January 26, 2018]. J Clin Apher. doi:10.1002/jca.21615.