Sustained decreases in platelet count associated with multiple, regular plateletpheresis donations.

BACKGROUND: Transient but significant decreases in platelet counts have been documented to occur in donors undergoing single and serial short-term plateletpheresis collections. The effect of long-term regular plateletpheresis on donor platelet counts has not been characterized. STUDY DESIGN AND METHODS: A retrospective study was performed to evaluate the effects of long-term regular plateletpheresis donation on donor platelet counts. A computerized database containing records of 11,464 apheresis collections from 939 donors over a 4-year period was queried for serial preapheresis platelet counts. Donors were categorized by sex, age, and cumulative number of donations. The average difference in platelet counts (mDeltaPC) between each donor's first and last platelet count during this period was calculated for each category. A subgroup of frequent donors was selected for analysis of mDeltaPC, using the baseline platelet count obtained before the first plateletpheresis procedure. RESULTS: A significant and sustained decrease in platelet count was identified for all donation frequency categories. The frequency of donation correlated directly with decrease in platelet count for all but the highest-frequency donation group, in which deferrals for low platelet count blunted the extent of the mDeltaPC. A mean decrease of 40,000 per microL from baseline occurred in the frequent-donor subgroup. A total of 84 donors (9%) were deferred for low platelet count. The majority returned to donate successfully after temporary deferral. CONCLUSIONS: Regular plateletpheresis donors develop sustained decreases in platelet count. However, clinically significant thrombocytopenia is unusual when rigorous ongoing review and prudent deferral policies are established and followed.

Protease inhibitor use among a community sample of people with HIV disease.

OBJECTIVES: Protease inhibitors have become integral to HIV disease management. This paper examines sociodemographic factors affecting patient use and perceived knowledge of protease inhibitors, and the relationship between protease inhibitor use and perceived health. METHODS: 1034 people with HIV disease from a large AIDS services organization completed a mailed self-administered survey that assessed sociodemographics, protease inhibitor use and perceived knowledge, and perceived change in health status over the previous year. Multiple logistic regression was used to determine sociodemographic factors independently associated with protease inhibitor use and perceived knowledge, and perceived overall health status. RESULTS: Two thirds (66%) of correspondents included in the sample were currently taking protease inhibitors and 52% reported being very knowledgeable about these medications. Adjusting for sociodemographic factors, those who were currently not taking protease inhibitors were more likely to be African American, non-English speaking, earning <$9600 U.S. annually, or uninsured. Among protease inhibitor users, those who reported less knowledge about the drugs were more likely to be nonwhite, earning <$9600 U.S. annually, and not college educated. Protease inhibitor use was independently associated with perceived improved overall health and having been college educated. CONCLUSIONS: Further efforts should be directed toward increasing use and knowledge of protease inhibitors among disadvantaged populations.