The characteristics of HIV and AIDS patients with deep vein thrombosis at Dr. George Mukhari Academic Hospital.

Indiran Govender,Gboyega A Ogunbanjo,Honey L Mabuza

doi:10.4102/phcfm.v7i1.690

Abstract

BackgroundDeep vein thrombosis (DVT) is 10 times more prevalent in HIV and AIDS patients than in the general population and is more common in patients with severe immune suppression (CD4 < 200 cells/mL). Opportunistic infections render HIV and AIDS patients susceptible to a hypercoaguable state, including lower protein S levels.Aim and settingTo present the profile of HIV and AIDS patients who developed DVT in the primary care wards of Dr. George Mukhari Academic Hospital (DGMAH), Garankuwa.MethodsCross-sectional study of clinical records of admitted HIV and AIDS patients without DVT to the primary care wards, DGMAH, from 01 February 2010 to 31 January 2011.ResultsTwo hundred and twenty-nine patients were admitted and 17 (7.4%) developed DVT. Of those that developed DVT, eight (47%) had infection with tuberculosis (TB), four (24%) had pneumonia and four (24%) had gastroenteritis. The risk of developing DVT was 8/94 (8.5%) in those with TB, 4/53 (7.5%) in those with gastroenteritis and 4/75 (5.3%) in those with pneumonia. The mean duration of stay was 14.1 days in those with DVT versus 4.0 days in those without.ConclusionHIV (and AIDS) is a hypercoaguable state and the risk of DVT is relatively high in patients with opportunistic infections. HIV and AIDS patients who are admitted to hospital with opportunistic infections may benefit from anti-thrombotic prophylaxis and further studies are needed to evaluate this.

Highlights

Opportunistic infections increase the risk of HIV and AIDS patients having a thromboembolic event by lowering protein S levels and through immobility.[4,5]
We present a profile of HIV and AIDS patients with concomitant Deep vein thrombosis (DVT) in the primary care wards of Dr George Mukhari Academic Hospital (DGMAH), GaRankuwa
This was a cross-sectional study of clinical records of HIV and AIDS patients admitted to the primary care wards at DGMAH without concomitant DVT from 01 February 2010 to 31 January 2011

Summary

Introduction

Deep vein thrombosis (DVT) is 10 times more common in HIV and AIDS patients, in those with severe immune suppression (CD4 < 200 cells/mL).[1,2,3] Opportunistic infections increase the risk of HIV and AIDS patients having a thromboembolic event by lowering protein S levels and through immobility.[4,5] Such chronic inflammation in patients with HIV can elevate C4b-binding protein, which binds protein S and decreases free levels.[6] Patients seen with DVT are more likely to be HIV-positive.[7]. Deep vein thrombosis (DVT) is 10 times more prevalent in HIV and AIDS patients than in the general population and is more common in patients with severe immune suppression (CD4 < 200 cells/mL). Opportunistic infections render HIV and AIDS patients susceptible to a hypercoaguable state, including lower protein S levels

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Discussion

Conclusion