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HIV-Associated ITP — SCE Infectious Diseases MCQ

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ModerateHIV MedicineHIV-Associated ITPSCE Infectious Diseases

A 50-year-old HIV-positive man (CD4 350, VL <50 on ART) develops immune thrombocytopenic purpura (ITP). His platelet count is 18 × 10⁹/L with mucosal bleeding. He is on DTG/TAF/FTC. What is the relationship between HIV and ITP?

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Correct answer: A — HIV-associated ITP is common and often responds to optimisation of ART; additional ITP-specific treatment may be needed

HIV-associated ITP is a well-recognised autoimmune complication of HIV infection, occurring at any CD4 count. Autoantibodies against platelet glycoproteins (anti-GPIIb/IIIa) and immune complex deposition cause platelet destruction. Many patients improve with effective ART alone. If platelet count remains dangerously low despite ART, standard ITP treatments (corticosteroids, IVIG, Eltrombopag) may be used. Splenectomy is reserved for refractory cases. Antiretroviral drugs rarely cause thrombocytopenia.

Reference: BHIVA 2022 – Haematological complications of HIV; BSH 2019 – ITP guidelines