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Case report
The importance of CD4 count, viral load and highly active antiretroviral therapy in HIV-associated thrombotic thrombocytopenic purpura (TTP)
  1. Quentin A Hill1,
  2. Jane Minton2
  1. 1Department of Haematology, St James's Institute of Oncology, Leeds, UK
  2. 2Department of Infection and Travel Medicine, St James's University Hospital, Leeds, UK
  1. Correspondence to Dr Quentin A Hill, Department of Haematology, St James's Institute of Oncology, Leeds Teaching Hospitals, Leeds, UK; quentinhill{at}


A case is reported of HIV-associated thrombotic thrombocytopenic purpura with normal CD4 count but high HIV viral load, developing neurological and cardiac complications up to 36 days after initiation of plasma exchange, but remitting within 18 days of the start of highly active antiretroviral therapy and steroids. In addition to plasma exchange, prompt initiation of highly active antiretroviral therapy in patients with HIV-associated thrombotic thrombocytopenic purpura may be justified despite a normal CD4 count.

  • HIV
  • thrombotic thrombocytopenic purpura
  • TTP
  • thrombotic microangiopathy
  • viral infection: HAART
  • immunodeficiency
  • HIV clinical care
  • intensive care
  • anteretroviral therapy
  • virology HIV
  • CD4

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  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.