Тромботическая болезнь
В ряде случаев докладывается о венозных тромбозах, сопровождающих ВИЧ-инфекцию. При проведении исследования (Multistate Adult and Adolescent Spectrum of HIV Disease Surveillance Project sponsored by the CDC) случаи тромбозов среди 42 935 ВИЧ-инфицированных пациентов установлено to be 2,6 per 1000 person-years, что значительно выше, чем в основной популяции. К факторам, предрасполагающим к тромботической болезни, относят возраст старше 45 лет, СМВ-ретиниты и другие инфекции, другие оппортунистические инфекции при СПИДе, иммобилизация, использование мегестрол ацетата, использование индинавира. Использование других противоретровирусных препаратов пол, раса, способ передачи ВИЧ, не связаны с повышенным риском тромбозов.
Дополнительными факторами, имеющими этиологическое значение при тромбоэмболических нарушениях ассоциированных с ВИЧ, являются: приобретенный дефицит протеина S, антитела к антикардиолипину, дефицит кофактора гепарина II и другие.
Выводы. ВИЧ-инфекция связана со множеством нарушений љгемопоэза, заключающихся в отклонениях на уровне гемопоэтических стволовых клеток, расстройствах костномозгового микроокружения и нарушении продукции љгемопоэтических ростовых факторов, влияющих на продукцию и функционирование клеток крови. Различных инфекций и опухоли могут изменять продукцию клеток крови. Для нормализации гемопоэза применяется множество препаратов. Специфическая оценка љцитопений зависит от типа первичного повреждения клеток крови, а выбор специфического лечения зависит от варианта расстройства, что очерчено в данном тексте и таблицах.
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