PB2039 PLATELET INDICES, COAGULATION BIOMARKERS AND CARDIOVASCULAR RISK FACTORS IN TREATMENT‐NAÏVE HIV‐INFECTED ADULTS IN LAGOS UNIVERSITY TEACHING HOSPITAL

Abstract

Background:With the use of antiretroviral therapy, the incidence of AIDS‐defining illnesses and opportunistic infections has reduced significantly, leading to increased life span of human immunodeficiency virus (HIV)‐infected individuals. Non‐infectious causes of morbidity and mortality, including cardiovascular diseases, have since emerged. Platelet indices and coagulation biomarkers are surrogate markers of cardiovascular risk in several disease conditions but their relevance in HIV infection is uncertain.Aims:The aim of this study was to evaluate platelet indices and coagulation biomarkers in untreated HIV infection and to determine their relationship with HIV disease severity and cardiovascular risk factors.Methods:A cross‐sectional study of 115 treatment‐naïve HIV‐infected adult patients attending the HIV clinic of the Lagos University Teaching Hospital and 115 age‐ and gender‐matched non‐infected adults was carried out. Socio‐demographic characteristics and history of cardiovascular risk factors were obtained from all participants, followed by body mass index (BMI) and blood pressure measurements and World Health Organization (WHO) clinical staging of the HIV‐infected subjects.Laboratory evaluation of full blood count, including platelet indices; platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT), CD4+ T lymphocyte count, fasting lipid profile, fasting plasma glucose, fibrinogen and D‐dimer levels were done for all participants.Results:The HIV‐infected group had significantly higher MPV (9.2 ± 1.0fL vs.8.5 ± 0.8 fL, P < 0.01), PDW (15.7 ± 0.4% vs.15.6 ± 0.4%, P = 0.01), PCT (0.236 ± 0.095% vs. 0.201 ± 0.051%, P < 0.01) and fibrinogen levels (250.2 ± 93.4 mg/dL vs. 193.6 ± 46.8 mg/dL, P < 0.01) than the non‐infected group. There was no significant difference in the platelet count [244 (187‐305) vs. 241 (192‐271) x109/L, P = 0.31] and D‐dimer levels [395.08 (303.23‐519.45) vs. 399.42 (316.35‐483.58) ng/mL, P = 0.96) between the HIV‐infected subjects and the non‐infected controls.The CD4+ T lymphocyte count inversely correlated with PDW (r = ‐0.248, P < 0.01) and fibrinogen levels (r = ‐0.229, P = 0.01) while the WHO clinical stage directly correlated with fibrinogen levels (r = 0.193, P = 0.04) in the HIV‐infected subjects. Lower BMI was associated with higher PLT (β = ‐0.258, P < 0.01) and PCT (β = ‐0.278, P < 0.01) while higher triglyceride (β = 0.292, P < 0.01) and HDL‐cholesterol levels (β = 0.213, P = 0.04) were associated with higher PDW in the HIV‐infected subjects. Diabetes was associated with higher fibrinogen levels in the HIV‐infected subjects (β = 0.276, P < 0.01).Summary/Conclusion:Platelet indices and fibrinogen levels are increased in HIV infection. Platelet distribution width and fibrinogen levels increase with HIV disease severity. Cardiovascular risk factors including diabetes mellitus and dyslipidaemia are associated with increase in platelet indices and fibrinogen levels in HIV infection.image