Patients with HIV/AIDS are prone to develop multiple complications and comorbidities. The hematological complications including cytopenias, lymphoma, multiple myeloma, bone-marrow dysplasia, and coagulation disorders are common. Anemia is the most common cytopenia and develops in almost all patients with HIV/AIDS. Autoimmune Haemolytic Anaemia (AIHA) is a rare cause of anemia in persons infected with HIV. AIHA usually occurs at an advanced stage of HIV disease. The mortality in AIHA is about 11%. RBC autoantibodies are frequently detected after blood transfusion in patients with HIV/AIDS, necessitating screening of patients with anemia for autoantibodies. AIHA may lead to life-threatening thromboembolic complications. Therefore, RBC transfusions should be limited only to cases with severe anemia. Steroids are the first line of treatment. Rituximab, immunosuppressants, and finally, splenectomy are the therapeutic options for steroid-refractory patients. We report two female patients infected with HIV/AIDS who presented with severe anemia and positive Coomb’s Test. Both patients were successfully managed as AIHA with blood transfusion, steroids, and immunosuppressants.
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