This report highlights pure red cell aplasia and immunosuppressive therapy in an HIV-positive individual, indicating the need for awareness of hematological complications.
We present a case of Pure Red Cell Aplasia (PRCA) secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a human immunodeficiency virus (HIV)-positive patient. To our knowledge, this is the first reported case of SARS-CoV-2-associated PRCA in an HIV-positive individual. The patient received immunosuppressive therapy (IST):initial treatment with corticosteroids was later switched to cyclosporine A (CsA), and he ultimately achieved complete remission. Additionally, we reviewed previously reported cases of SARS-CoV-2-associated PRCA. These findings emphasize that hematological abnormalities should also be recognized as a critical extrapulmonary complication of SARS-CoV-2 infection. In conclusion, SARS-CoV-2 infection can affect bone marrow tissue, leading to a spectrum of hematological abnormalities and subsequent clinical sequelae. For HIV-positive patients presenting with PRCA, antiretroviral drugs and acute or chronic infections should be prioritized in the diagnostic workup.
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Wang et al. (2025) studied this question.
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