The most effective treatment for thrombocytopenia in HIV-positive people is anti-HIV drug treatment. Because anti-HIV drugs are effective in reducing the amount of virus in the blood, they can help prevent HIV from infecting megakaryocytes. Anti-HIV drug treatment can also help calm down the immune system, which may slow or stop the production of autoantibodies causing the thrombocytopenia.
If anti-HIV drug treatment is not effective, a number of other treatments are possible. These include:
Thrombocytopenia Treatments
Prednisone: Prednisone is a steroid medication that is similar to cortisone, a hormone that your adrenal gland produces. It has many uses, and is used to treat immune thrombocytopenic pupura (ITP) because it can calm down a hyperactive immune system and has been shown to increase platelet counts. Long-term prednisone use can suppress the immune system, which can be problematic for HIV-positive people.
Gamma Globulin (IVIg): IVIg is sometimes given alone or in combination with prednisone to increase the platelet count. It is given intravenously over four to six hours and is sometimes given for one to three days at a time.
Rh0 [D] Immune Globulin (WinRho®): WinRho®, also known as anti-D, is approved for people with Rh0 [D]-positive blood who have ITP. It contains antibodies specific to Rh0 antigen (also called the D antigen) located on red blood cells. These anti-D antibodies raise platelet counts by attaching or binding to the Rh0 antigen on red blood cells. The antibody-coated red blood cells temporarily prevent the spleen from destroying your platelets. It is given as an intravenous injection, once every month if needed.
Splenectomy: This is a surgery to remove the spleen. By removing the spleen, the organ responsible for removing platelets attacked by autoantibodies, ITP is theoretically cured. However, this approach is not usually recommended until other, less serious and less risky treatments have been tried.
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