What is used to treat neutropenia in pediatric HIV infection and what is the recommended regimen?

Updated: Mar 05, 2020
  • Author: Delia M Rivera, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Granulocyte-macrophage colony-stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF) are used to treat neutropenia and to promote granulocyte production and function. GM-CSF has more adverse effects than G-CSF, and it promotes viral replication. However, GM-CSF does not increase the viral load if it is used with ART.

G-CSF is started at a dosage of 5 mcg/kg/day, and it is given until neutropenia resolves. Titration to once or twice per week is typical. Adverse effects of G-CSF are minimal and include bone pain and elevations in lactate dehydrogenase (LDH) and alkaline phosphatase levels. GM-CSF is started at a dosage of 5 mcg/kg/d given subcutaneously for 5 days and then titrated to effect. Adverse effects include flulike symptoms, myalgias, bone pain, fatigue, and fever.


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