BACKGROUND AND OBJECTIVE: Atherosclerosis and other cardiovascular diseases associated with thrombosis appear more relevant and anticipated in HIV-infected patients after combination antiretroviral therapy (cART) has reduced AIDS-related diseases and has improved survival. The association between viral replication and coagulation abnormalities in a cohort of HIV-infected children and adolescents was investigated here. METHODS: Protein S, protein C anticoagulant and antithrombin activity, together with fibrinogen, D-dimer, high-sensitive C-reactive protein and homocysteine were assayed in a cross-sectional study among a cohort of HIV-infected children and adolescents. Results in patients with high viral load (HVL, HIV-RNA > 1000 copies/ml) were compared with those in patients with a lower replication (LVL), adjusting for other demographic, clinical and therapeutic covariates. RESULTS: Eighty-eight patients (mean age 13.5 years, CD4 30%, 72% with LVL) were enrolled. A prevalence of protein S and protein C deficiency of 51 and 8% was, respectively, found. HVL group compared to LVL showed a significant reduction of protein S, protein C and antithrombin activities, and an increase of D-dimer levels. The independent association of HVL with decreased protein S activity (-11.2%, P = 0.04) and increased D-dimer levels (+0.13 microg/ml, P = 0.004) was confirmed in the multivariate model. CONCLUSIONS: HIV-infected children and adolescents present high prevalence of thrombophilic abnormalities. The multivariate model confirmed that high viral replication is independently associated with decrease of protein S and increase of D-dimer, suggesting the advantage of suppressive therapy on coagulation homeostasis and the opportunity of an active control of cardiovascular risk factors starting at a younger age.
BACKGROUND AND OBJECTIVE:Atherosclerosis and other cardiovascular diseases associated with thrombosis appear more relevant and anticipated in HIV-infectedpatients after combination antiretroviral therapy (cART) has reduced AIDS-related diseases and has improved survival. The association between viral replication and coagulation abnormalities in a cohort of HIV-infectedchildren and adolescents was investigated here. METHODS: Protein S, protein C anticoagulant and antithrombin activity, together with fibrinogen, D-dimer, high-sensitive C-reactive protein and homocysteine were assayed in a cross-sectional study among a cohort of HIV-infectedchildren and adolescents. Results in patients with high viral load (HVL, HIV-RNA > 1000 copies/ml) were compared with those in patients with a lower replication (LVL), adjusting for other demographic, clinical and therapeutic covariates. RESULTS: Eighty-eight patients (mean age 13.5 years, CD4 30%, 72% with LVL) were enrolled. A prevalence of protein S and protein C deficiency of 51 and 8% was, respectively, found. HVL group compared to LVL showed a significant reduction of protein S, protein C and antithrombin activities, and an increase of D-dimer levels. The independent association of HVL with decreased protein S activity (-11.2%, P = 0.04) and increased D-dimer levels (+0.13 microg/ml, P = 0.004) was confirmed in the multivariate model. CONCLUSIONS:HIV-infectedchildren and adolescents present high prevalence of thrombophilic abnormalities. The multivariate model confirmed that high viral replication is independently associated with decrease of protein S and increase of D-dimer, suggesting the advantage of suppressive therapy on coagulation homeostasis and the opportunity of an active control of cardiovascular risk factors starting at a younger age.
Authors: C Blokhuis; C F W Peeters; S Cohen; H J Scherpbier; T W Kuijpers; P Reiss; N A Kootstra; C E Teunissen; D Pajkrt Journal: Sci Rep Date: 2019-05-29 Impact factor: 4.379
Authors: Fatai O Bello; Alani S Akanmu; Titilope A Adeyemo; Bukunmi M Idowu; Prosper Okonkwo; Phyllis J Kanki Journal: South Afr J HIV Med Date: 2021-08-23 Impact factor: 2.744
Authors: Marilza Campos de Magalhães; Juan Camilo Sánchez-Arcila; Ana Carolina de Brito Lyra; Luiz Felipe Boufleur Long; Isabelle Vasconcellos de Souza; Fernando Raphael de Almeida Ferry; Adilson José de Almeida; Soniza Vieira Alves-Leon Journal: PLoS One Date: 2020-02-12 Impact factor: 3.240