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International Journal of Infectious Diseases: Volume 3, Number 2
Outcomes of Granulocyte Colony-Stimulating Factor or Granulocyte-Macrophage Colony- Stimulating Factor Use in Neutropenic Patients Infected with Human Immunodeficiency Virus
Balamurali K. Ambati, MD; David C. Perlman, MD; and Nadim Salomon, MD

Int J Infect Dis 1999; 3:70-75.

Objective: To characterize the effects of granulocyte colony-stimulating factor (G-CSF) or granulocyte-macrophage colony-stimulating factor (GM-CSF) on clinical outcomes in neutropenic HIV-infected patients, by means of a retrospective cohort study at an urban teaching hospital. Method: Data were reviewed from all patients discharged between January 1, 1996, and August 31, 1997, with human immunodeficiency virus and neutropenia (absolute neutrophil count (ANC) <1000 cells/mL), with outcome measures of length of stay, infectious complications, and survival to discharge. Results: Of the 228 discharged patients who met selection criteria, 71 had received G-CSF or GM-CSF; 157 controls had not. Cases had lower CD4+ cell counts (30 vs. 54 cells/mL; P = 0.017) and lower nadir ANCs (372 vs. 579 cells/mL; P < 0.001). Granulocyte-CSF or GM-CSF usage was not associated with the frequency of site-related infections, fever, or sepsis (all P > 0.20). No difference was found in duration of hospitalization (23 vs. 21 days; P > 0.20). In a logistic regression model for survival to discharge, higher nadir ANC and CSF use were independently associated with improved survival (P = 0.034 and P = 0.026, respectively). Conclusion: Use of G-CSF or GM-CSF was associated with improved survival to discharge among hospitalized HIV-infected patients with neutropenia.

KEYWORDS:granulocyte-colony stimulating factor, granulocyte-macrophage colony stimulating factor, HIV, neutropenia

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