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Platelet and coagulation defects associated with HIV-1-infection.

HIV-1 seropositive individuals: homosexuals (1), intravenous narcotic addicts (2), hemophiliacs (3), and their heterosexual partners (4) develop chronic immunologic thrombocytopenic purpura (ITP). The thrombocytopenia can present early in the course of HIV-1-infection as well as in association with AIDS. The early onset disease (emphasized in this review) is clinically indistinguishable from classic autoimmune thrombocytopenic purpura (ATP) seen predominantly in females, with respect to increased megakaryocytes in the bone marrow, peripheral destruction of antibody-coated platelets and/or impaired platelet production, negative antinuclear antibody, and response to prednisone, i.v. globulin and/or splenectomy. The disease is different from classic ATP with respect to the markedly increased platelet-associated IgG, C3C4, the presence of circulating immune complexes and the male predominance.