Human Immune-Deficiency Virus Associated Deep Vein Thrombosis Coexisting with Venous Ulcer

Abstract

Human immune-deficiency virus (HIV) infection is known to be a prothrombotic condition especially when advanced and characterized by low CD4+ count and high viral load, and treated with protease inhibitor(s). In such cohort of HIV infected patients the prevalence of deep vein thrombosis is up to 10-fold of that found in the general population.This is the case report of a 48-year old man with advance HIV infection with associated left leg venous ulcer who was receiving a protease inhibitor presenting with left lower extremity deep vein thrombosis. He was admitted, evaluated, investigated and treated with low molecular weight heparin (Enoxaparin) and warfarin, and non-pharmacologic supportive therapy while on his highly active anti-retroviral therapy (HAART). After three weeks on inpatient treatment, the venous ulcer healed and the deep vein thrombosis resolved. The patient was discharged to continue warfarin for six months and has remained well 30 months since discharge. The prevalence of deep vein thrombosis is about 10-fold greater in HIV infection but the treatment remains same as in non-HIV infected patients.