Abstract
Introduction: Aging and chronic HIV infection are clinical conditions that share the states of inflammation and hypercoagulability. The life expectancy of the world population has increased in the last decades, bringing as complications the occurrence of diseases that undergoing metabolic, bone, cardiological, vascular and neurological alterations. HIV-infected patients experience these changes early and are living longer due to the success of antiretroviral therapy. The objectives of this study was to evaluate some changes in the plasma hemostatic profile of 115 HIV-reactive elderly individuals over 60 years old in the chronic phase of infection, and compare with 88 healthy uninfected elderly individuals. Plasma determinations of D-dimers, Fibrinogen, von Willebrand Factor, Antithrombin, Prothrombin Time, Activated Partial Thromboplastin Time, and platelet count were performed. In the HIV-reactive group, these variables were analyzed according to viral load, protease inhibitor use and CD4+ T lymphocyte values. After adjusted values for age and sex, the results showed higher levels of Antithrombin (103%; 88%, p = 0.0001) and Prothrombin Time activities (92.4%; 88.2%, p = 0.019) in the HIV group compared to the control group. We observed higher values of Fibrinogen in protease inhibitor users in both the male (p = 0.043) and female (p = 0.004) groups, and in the female HIV group with detected viral load (p = 0.015). The male HIV group with a CD4+ count> 400 cells / mm3 presented higher von Willebrand Factor values (p = 0.036). D-Dimers had higher values in the older age groups (p = 0.003; p = 0.042, respectively). Conclusion: Our results suggest that the elderly with chronic HIV infection with few comorbidities had a better hemostatic profile than negative control group, reflecting the success of treatment. Protease inhibitor use and age punctually altered this profile.
Highlights
Aging and chronic HIV infection are clinical conditions that share the states of inflammation and hypercoagulability
Female study group (SG) was composed of 63 participants (54.80%) and male by 52 (45.20%)
The female control group (CG) group consisted of 64 participants (72.70%) and the male group by 24 (27.30%)
Summary
Aging and chronic HIV infection are clinical conditions that share the states of inflammation and hypercoagulability. Chronic infection of HIV promotes changes in hemostasis and coagulation inconsequence of persistent systemic immune activation, micro- and macro-vascular disease, and, potentially, impaired hepatic synthesis of coagulation factors [17] Futhermore, in these patients, the aging process starts early compared to the general population, due to the increase of complicating factors and other diseases [18,19,20]. Markers of biological and cellular aging are common in HIV-reactive patients [21] They affect lymphocytes and monocytes, increase inflammatory proteins and, when activated by the inflammatory response, express in their cytoplasmic membranes the Tissue Factor (TF), initiating coagulation [22,23,24,25,26].Studies started before and after ART, when compared to others in the geriatric area, confirm the common pre-thrombotic state among the two groups [27,28]. This pre-thrombotic state is usually associated with comorbidities and severity of infection [29], making the association a risk factor for mortality and for the survival rate of these patients not yet the same as the general population [10,24,30,31,32,33]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
