Abstract
BackgroundHIV is a chronic inflammatory state with the production of many acute-phase-reactant proteins. Some of these proteins have procoagulant activities that predispose HIV-infected patients to thrombosis.ObjectivesThe aim of the study was to evaluate the effects of HIV infection on the serum levels of C4b-binding protein (C4BP) and protein S as markers of predisposition to thrombosis in HIV-infected adults.MethodsThe study population comprised of 61 HIV-infected adults on antiretroviral treatment (ART) who had achieved virological suppression, 58 HIV-infected adults not yet on ART and 59 HIV-negative healthy controls. The serum levels of free protein S, C4BP and the euglobulin clot lysis time (ECLT) were determined.ResultsThe mean plasma-free protein S level of HIV-infected patients on ART (86.9% ± 25.8%) was significantly higher than that of treatment-naïve HIV-infected patients (75.7% ± 27.3%) (p = 0.005). Conversely, there was no statistically significant difference between the protein S levels of the HIV-infected subjects on ART (86.9% ± 25.8%) and those of the controls (94.9% ± 7.9%) (p = 0.119). The mean C4BP was significantly higher in the treatment-naïve HIV-infected subjects (36.7 ± 1.7 ng/dL) than that in those on ART (30.7 ± 2.6 ng/dL) and that in the controls (22.4 ± 2.4 ng/dL) (p < 0.0001). Protein S deficiency was more prevalent among the subjects with elevated C4BP (p = 0.023). The mean ECLT was significantly more prolonged in the treatment-naïve HIV-infected subjects (241.9 ± 34.7 s) than controls (189.5 ± 40.7 s) (p < 0.0001).ConclusionHIV infection causes elevated levels of C4BP and diminishes the serum levels of free protein S. We infer that the risk of thrombosis (as measured by these biomarkers) decreases with the use of antiretroviral drugs.
Highlights
The introduction of antiretroviral treatment (ART) has dramatically improved the survival of persons living with HIV (PLWH).chronic complications from the infection and from ART itself are critical issues that confront healthcare providers managing HIV-infected patients
The antiretroviral clinic supported by the AIDS Prevention Initiative in Nigeria (APIN) at the Lagos University Teaching Hospital (LUTH), Lagos, was established in October 2004
Forty-eight HIV-infected patients on ART were on a combination of two nucleoside reverse transcriptase inhibitors (NRTIs) and one non-nucleoside reverse transcriptase inhibitor (NNRTI), while 13/61 patients were on regimens comprising a boosted protease inhibitor (PI) and two NRTIs (Table 1)
Summary
The introduction of antiretroviral treatment (ART) has dramatically improved the survival of persons living with HIV (PLWH).chronic complications from the infection and from ART itself are critical issues that confront healthcare providers managing HIV-infected patients. HIV is a chronic inflammatory state that results in the production of a variety of acute-phase-reactant proteins. These acute-phase reactants may predispose HIV-infected patients to thrombosis.[1]. The most important fibrinolytic protein is plasminogen, which is normally activated by tissue plasminogen activator (tPA) to generate plasmin (the most potent protein capable of lysing thrombus). HIV is a chronic inflammatory state with the production of many acute-phasereactant proteins. Some of these proteins have procoagulant activities that predispose HIVinfected patients to thrombosis
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