Anti-GPIIIa antibody and CD4 count identify an autoimmune-enriched phenotype of HIV-associated thrombocytopenia: development and internal validation of a clinical nomogram - Report - MDSpire

Anti-GPIIIa antibody and CD4 count identify an autoimmune-enriched phenotype of HIV-associated thrombocytopenia: development and internal validation of a clinical nomogram

  • By

  • Xia Liu

  • Lemin Wen

  • Zhoulin Zhong

  • Hangbiao Qiang

  • Lida Mo

  • Wenyi Dong

  • Wen Huang

  • Shuyu Nong

  • Zheng Huang

  • Zhiman Xie

  • Mei Yu

  • July 7, 2026

  • 0 min

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Clinical Report: Identification of an Autoimmune-Enriched Phenotype in HIV-Related Thrombocytopenia

Overview

This study identifies an autoimmune-enriched phenotype in HIV-related thrombocytopenia characterized by anti-GPIIIa antibody positivity.

Background

Thrombocytopenia is a common complication in HIV-infected individuals, affecting a significant percentage of both untreated and treated patients. Distinguishing the underlying causes of thrombocytopenia, particularly between autoimmune destruction and advanced immunodeficiency, is crucial for effective management. Current diagnostic methods often fail to adequately stratify these patients.

Data Highlights

VariableValue
Anti-GPIIIIa antibody positivityaOR = 35.3; 95% CI: 9.2–135.6; P < 0.001
Final model AUC0.862 (95% CI: 0.811–0.913)
Specificity96.9%
Positive predictive value95.6%
Bootstrap-corrected AUC0.857
Mean cross-validation AUC0.867 ± 0.055

Key Findings

  • Anti-GPIIIa antibody positivity is the strongest predictor of thrombocytopenia in HIV-infected individuals.
  • The final model includes anti-GPIIIa antibody, CD4+ count, albumin, and neutrophil count.
  • The model achieved a high AUC of 0.862, indicating strong predictive capability.
  • Internal validation confirmed the model's robustness with a bootstrap-corrected AUC of 0.857.
  • Distinct risk trajectories were observed based on CD4+ counts and anti-GPIIIa antibody status.

Clinical Implications

Understanding the autoimmune component of thrombocytopenia may influence management strategies in this population.

Conclusion

The study presents a clinically relevant model for identifying an autoimmune-enriched phenotype in HIV-related thrombocytopenia.

Related Resources & Content

  1. American Society of Hematology 2019 guidelines for immune thrombocytopenia | Blood Advances | American Society of Hematology
  2. Thrombocytopenia and immune thrombocytopenic purpura - HIV Management Guidelines
  3. Frontiers in Pediatrics — Development and validation of a predictive model for chronic or persistent immune thrombocytopenia in children incorporating anti-glycoprotein IIb antibody: a retrospective cohort study utilizing LASSO regression and bootstrap stability analysis
  4. Frontiers in Immunology — CD4/CD8 ratio is associated with structural reorganization of vaccine-induced immune responses in people living with HIV
  5. Open Forum Infectious Diseases — Changes in T-Cell Phenotype Over Time During Extended Antiretroviral Treatment in Individuals Living with HIV
  6. Blood Cancer Journal — Frequency of Monoclonal Gammopathy of Undetermined Significance (MGUS) at the Time of HIV Diagnosis in Young Adults Aged 18–40: Potential Indicator for HIV Infection
  7. American Society of Hematology 2019 guidelines for immune thrombocytopenia | Blood Advances | American Society of Hematology
  8. Thrombocytopenia and immune thrombocytopenic purpura - HIV Management Guidelines
  9. GPIIIa-(49–66) is a major pathophysiologically relevant antigenic determinant for anti-platelet GPIIIa of HIV-1-related immunologic thrombocytopenia - PMC

Original Source(s)

Anti-GPIIIa antibody and CD4 count identify an autoimmune-enriched phenotype of HIV-associated thrombocytopenia: development and internal validation of a clinical nomogram

  • by Xia Liu, Lemin Wen, Zhoulin Zhong, Hangbiao Qiang, Lida Mo, Wenyi Dong, Wen Huang, Shuyu Nong, Zheng Huang, Zhiman Xie, Mei Yu

  • July 7, 2026

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