Zhuoyun Tang, Zhonghao Wang, Tingting Wang, Dongdong Li, Jingyi Li, Chaonan Liu, Chuanmin Tao

Department of Laboratory Medicine, Clinical Laboratory Medicine Research Center, West China Hospital, Sichuan University, Sichuan Clinical Research Center for Laboratory Medicine, Chengdu, 610041, People’s Republic of China

Correspondence: Chuanmin Tao, Email taocm@scu.edu.cn

Background: Thrombocytopenia frequently occurs with HIV-1 infection and plays a vital role in the deterioration of the Blood-Brain Barrier (BBB) and the development of neuroinflammation. This study aims to assess the prevalence and risk factors for HIV-1 associated thrombocytopenia (HAT) and summarize the characteristics of HAT-related neuroinflammation.
Methods: A retrospective study of HAT patients was conducted in a general teaching hospital from January 2017 to December 2021. Clinical and laboratory data from HIS and LIS were analyzed to determine the prevalence and risk factors for HAT and manifestations of HAT with neuroinflammation.
Results: The prevalence of HAT was 11.06%, with a majority of male patients (76.92%), individuals aged 50 and older (55.21%), and 63.80% experiencing mild thrombocytopenia. Significant differences were observed in CD4+ T cell count, platelet crit (PCT), and the proportion of large platelets (P-LCR) between the HAT and control groups (P< 0.001, P< 0.001, P=0.002). A CD4+ T cell count < 200 cells/μL (P=0.001) was identified as a significant risk factor for HAT, while advanced age and high viral load were closely associated with HAT occurrence. HAT Patients with neuroinflammation were predominantly male (X2=10.066, P=0.007), had higher viral loads (X2=12.297, P=0.006), advanced age (X2=11.721, P=0.02), neuropsychiatric symptoms, and elevated levels of inflammatory factors such as IL-6 and proteins in cerebrospinal fluid (CSF).
Conclusion: In HIV-1 infection, the activation of monocytes, macrophages, and microglia leads to thrombocytopenia and neuroinflammation, highlighting the importance of recognizing HAT and HAT with neuroinflammation. Advanced age, lower CD4+ T cell count, and high viral load are closely linked to their occurrence.

Keywords: HIV-1, thrombocytopenia, neuroinflammation, prevalence