Abstract
Introduction : Although combined Anti-Retroviral Therapy (cART) has improved the quality of life and survival in people living with HIV-AIDS (PLWHA), there have been reports of increased non-AIDS related co-morbidities such as coagulopathies. The objective of this study was to assess the effect of cART on the coagulation profile of PLWHA. Methods : This case-control study recruited 110 PLWHA (65 patients on cART, and 45 cART naive patients) from the antiretroviral therapy unit of Volta Regional Hospital, Ho. Blood was collected for prothrombin time (PT), activated partial thromboplastin time (APTT)and platelet count. Results : cART naive individuals had a high PT (p <0.001; 17.2 vs 13.8) and APTT (p = 0.081; 59.7 vs 55.3) compared to their counterparts on cART. Also, INR was significantly lower in cART-treated PLWHA (p<0.001). Platelet count was high in participants on therapy compared to their naive counterparts (204.7 vs 193.6, p = 0.402). Patients on zidovudine + nevirapin + efavirenz therapy had a significantly lower PT compared to those on zidovudine + lamivudine + efavirenz therapy {p = 0.02, 13.23 vs 14.66}. Additionally, PLWHA on zidovudine + nevirapin + efavirenz had reduced APTT compared to those on zidovudine + lamivudine + efavirenz therapy, or zidovudine + lamivudine+ nevirapine therapy (p = 0.058; 47.55 vs 56.81 vs 56.85 respectively). Conclusion : HIV infection adversely affects the coagulation profile in PLWHA which improves with cART. Barring the existence of other comorbidities, cART with zidovudine + nevirapin + efavirenz combination could be the treatment of choice as it significantly improves the coagulation profile in PLWHA.
Highlights
Combined Anti-Retroviral Therapy has improved the quality of life and survival in people living with Human immunodeficiency virus (HIV)-AIDS (PLWHA), there have been reports of increased non-AIDS related co-morbidities such as coagulopathies
Though the activated partial thromboplastin time (APTT) was lower in the patients on combined Anti-Retroviral Therapy (cART) compared to cART naïve patients, this did not reach statistical significance (p=0.081)
With regards to the APTT, participants on CB3 had lower mean APTT compared to CB1 or CB2 {47.55 versus 56.81 (CB1) or 56.85 (CB2); p=0.058}
Summary
Combined Anti-Retroviral Therapy (cART) has improved the quality of life and survival in people living with HIV-AIDS (PLWHA), there have been reports of increased non-AIDS related co-morbidities such as coagulopathies. Conclusion: HIV infection adversely affects the coagulation profile in PLWHA which improves with cART. Barring the existence of other comorbidities, cART with zidovudine + nevirapin + efavirenz combination could be the treatment of choice as it significantly improves the coagulation profile in PLWHA. In this study we sought to compare the coagulation profiles of HIV persons on cART to that of cART naïve HIV patients to assess the coagulation profiles and how cART therapy might impact these factors
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