# Acquired thrombotic thrombocytopenic purpura and HIV infection: a case report and review of the literature

## TL;DR

This paper reports a case of HIV-related thrombotic thrombocytopenic purpura and reviews how it overlaps with other TMA conditions.

## Contribution

The paper presents a rare case linking HIV diagnosis with aTTP and highlights the role of ART in treatment.

## Key findings

- A 46-year-old woman with TTP was diagnosed with HIV during ADAMTS13 relapse.
- Complete remission was achieved only through antiretroviral therapy.
- The paper reviews clinical features and treatment outcomes of HIV-related aTTP/TMA.

## Abstract

Human immunodeficiency virus (HIV) is a rare cause of thrombotic microangiopathies (TMA), that can present either with normal ADAMTS13 activity (referred as HIV-related TMA) or suppressed ADAMTS13 activity (referred as HIV-related acquired thrombotic thrombocytopenic purpura, aTTP). The distinct characteristics and management of these two conditions is poorly known, given their rarity and often overlapping features. Here, we report the case of a 46-year-old female patient with TTP who received a diagnosis of HIV infection at her ADAMTS13 relapse and obtained complete remission only with antiretroviral therapy (ART). Moreover, we summarize the existing evidence in the literature about clinical presentation, outcomes and treatment of HIV-related aTTP/TMA.