![]() bacteria, parvovirus), bone marrow infiltration by malignancy, and anaemia of chronic disease. TB, mycobacterium avium complex (MAC), cytomegalovirus (CMV), Ebstein-Barr virus) and conventional (e.g. 2 Many factors may contribute to the development of cytopaenias in HIV, including the virus itself that can infect progenitor cells directly, cytokine effects, reticulin fibrosis, altered immune function with auto-antibody production, micro-nutrient deficiency (folate, vitamin B 12, iron), co-infection with other agents both opportunistic (e.g. (For a review of the ethical and legal considerations of transfusion and HIV, with a specific focus on South Africa, please refer to Appendix 1.)Ĭlinically significant cytopaenias (anaemia, thrombocytopaenia, neutropaenia) are common in persons with HIV. This review should be read in conjunction with published national and international clinical guidelines. The objective of this review is not to provide a novel approach to the management of haematological conditions rather, it is intended to provide a practical and succinct review on the rational use of blood transfusion in the management of haematological abnormalities, focusing on conditions either unique to, or more frequently encountered in, HIV-infected patients. While the role of blood transfusion in the management of haematological conditions such as anaemia and thrombocytopaenia does not differ substantially between HIV-negative and HIV-positive patients, it is the authors’ experience that there is a general need to promote rational transfusion practice. There have been numerous requests from members of the Southern African HIV Clinicians Society for guidance and direction on blood transfusion in HIV-infected patients. Specific and careful consideration of each patient is therefore required when HIV-related anaemia or associated conditions raise the possibility of transfusion. The decision to transfuse should be based on an individual patient’s co-morbid and clinical status, rather than on laboratory indices only. Clinicians should consider non-transfusion options such as haematinics in the management of anaemia. This is contingent upon an appreciation of the risks of unnecessary transfusion. ![]() One means of reducing the risk of TTIs and properly managing haematological symptoms, especially in immunocompromised individuals, is appropriate clinical use of blood. ![]() There has been concerted international effort, expending considerable resources, to prevent transmission of TTIs through blood products and to provide safe blood products for transfusion. The emergence and recognition of HIV as a transfusion transmissible infection (TTI) in the early 1980s had a profound impact on blood services worldwide. ‘Blood transfusion is like marriage: it should not be entered upon lightly, unadvisedly or wantonly, or more often than is absolutely necessary.’ 1īlood services have been at the forefront of raising awareness of the HIV pandemic. ![]()
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