Bone marrow biopsy

In HIV disease, a bone marrow biopsy is usually carried out to find the cause of a persistent fever, anaemia (low blood count), or other blood disorder such as a low platelet count. It may also be necessary to assess the severity of a tumour. It is a routine procedure that can be done on the ward or in an outpatient clinic.

A sample of bone marrow is usually taken from the hip bone. To ensure the procedure is less painful, a local anaesthetic is injected into the skin and soft tissues over the bone. However, there is usually some pain once the effect of the local anaesthetic has worn off. Once the procedure is over, discomfort can be eased by use of an analgesic. Part of the sample is sent to the laboratory to be examined under the microscope (histology) and part is placed in special culture bottles to identify any infecting bacteria or fungi.

In HIV infection, bone marrow biopsy frequently helps determine the cause of unexplained fevers, anaemia, and other blood disorders. It is useful in diagnosing certain opportunistic infections (disseminated mycobacterium avium, coccidiomycosis, or histoplasmosis) and malignancies (Hodgkin's and non-Hodgkin's lymphoma).