Infection by the human immunodeficiency virus (HIV) results in hematologic perturbations which progress as the HIV infection advances) '2 The hematologic manifestation of HIV infection cause major morbidity in themselves. They also hinder treatment directed toward the primary viral infection and those directed toward the secondary infectious and neoplastic complications, often necessitating dose reductions or interruption of therapies, a,4 The consequences include emergence of drug-resistance organisms, and progression of infections or neoplasms. 3'4
The hematologic abnormalities encountered during the course of HIV infection are due to ineffective hematopoiesis compounded by peripheral destruction. Production problems result from the HIV infection itself, 5-9 opportunistic infections, neoplasms, and drugs. Opportunistic infections may involve the bone marrow and result in a reduction of hematopoietic potential. These include mycobacteria, 10 fungi, notably Cryptococcus and Histoplasma, and other viral infections such as hepatitis virus, cytomegalovirus, and parvovirus. 10-14 AIDS-related lymphomas may involve the bone marrow in up to one third of afflicted patients. 15 Drugs which are used to treat both the primary HIV infection, the opportunistic infections, and the neoplastic complications cause both disease-stage, and dose dependent suppression of hematopoiesis. 1'4' 10.16 Bone marrow examination has limitations as a diagnositic tool for the hematologic manifestations of HIV disease. Aberrations of the bone marrow are