A Case Report of Tenofovir-induced Pure Red Cell Aplasia in a Known Patient with HIV/AIDS

Abstract

Anemia in patients diagnosed with HIV/AIDS is attributed to generalized bone marrow failure or to autoimmune hemolytic processes. However, the two most frequent causes of anemia in these groups of patients are related to either the cytopathic effect of HIV or the antiretroviral drugs. This report was of a rare case of Tenofovir-induced Pure Red Cell Aplasia in a known Human Immunodeficiency Virus (HIV) disease patient on antiretroviral therapy ART, who presented with recurrent generalized body weakness, skin rash, easy fatigability on exertion of four months duration with a history of dizziness and palpitation. Laboratory workups were consistent with persistent anemia on account of which she was transfused with several units of blood since the commencement of Dolutegravir, Lamivudine and Tenofovir (DTG/3TC/TDF).  A change in HAART regimen with the removal of Tenofovir was followed by spontaneous gradual and remarkable improvement in packed Cell Volume (PCV). Although there was a paucity of data on Tenofovir-induced Pure Red Cell Aplasia, this report revealed that Tenofovir is a possible cause of Pure Red Cell Aplasia in patients receiving Tenofovir containing HAART regimen.