J Med Microbiol International Journal of Systematic and Evolutionary Microbiology
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J Med Microbiol 57 (2008), 1032-1035; DOI: 10.1099/jmm.0.47782-0
© 2008 Society for General Microbiology
ISSN 1473-5644

Case Report

Lamivudine-induced red cell aplasia

Melanie-Anne A. John1,{dagger}, Yasin A. Rhemtula2,{dagger}, Colin N. Menezes1,2 and Martin P. Grobusch1,2

1 Infectious Diseases Unit, Division of Clinical Microbiology and Infectious Diseases, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

2 Department of Internal Medicine, Helen Joseph Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Correspondence
Martin P. Grobusch
martin.grobusch{at}wits.ac.za

Received 25 January 2008
Accepted 7 April 2008

Anaemia is frequent in patients with human immunodeficiency virus infection, and antiretroviral drugs have been implicated. Whilst therapy-induced anaemia is more readily attributed to zidovudine, lamivudine-associated, potentially life-threatening, pure red cell aplasia (PRCA) has been less recognized in the past and is only infrequently documented in the literature. We report on a patient suffering from what turned out to be lamivudine-induced PRCA who required 15 units of blood within 3 weeks before recovering swiftly following lamivudine (3TC) treatment withdrawal. As reviewed here, the nature of this condition is not well described in general, the onset appears to be variable and occurs at any CD4+ count, but rapid improvement after cessation of drug administration appears to be a consistent feature.

Abbreviations: ARV, antiretroviral; EFV, efavirenz; HAART, highly active antiretroviral treatment; Hb, haemoglobin; NRTI, nucleoside reverse transcriptase inhibitor; PRCA, pure red cell aplasia; RPI, red cell production index; ZDV, zidovudine.

{dagger}These authors contributed equally to this work.






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