Discrepant coagulation profile in HIV infection: elevated D-dimer but impaired platelet aggregation and clot initiation

In HIV infection, cardiovascular disease (CVD) has emerged as a clinical problem, and elevated D-dimer has been reported. The pathophysiologic mechanisms underlying this remain unclear. We aimed to investigate whether untreated HIV-infected individuals display evidence of functional coagulopathy and...

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Veröffentlicht in:AIDS (London) 2013-11, Vol.27 (17), p.2749-2758
Hauptverfasser: HAUGAARD, Anna K, LUND, Tamara T, BIRCH, Carsten, RÖNSHOLT, Frederikke, TRØSEID, Marius, ULLUM, Henrik, GERSTOFT, Jan, JOHANSSON, Per I, NIELSEN, Susanne D, OSTROWSKI, Sisse R
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Sprache:eng
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Zusammenfassung:In HIV infection, cardiovascular disease (CVD) has emerged as a clinical problem, and elevated D-dimer has been reported. The pathophysiologic mechanisms underlying this remain unclear. We aimed to investigate whether untreated HIV-infected individuals display evidence of functional coagulopathy and whether this was associated with microbial translocation. The study population consisted of 50 HIV-infected untreated individuals and 50 HIV-infected individuals on combination antiretroviral therapy (cART). Groups were matched for age, sex and current CD4cell count. Coagulation analyses included D-dimer and the functional haemostatic whole blood tests, thromboelastography (TEG) and platelet aggregation (Multiplate, impedance aggregometry). Microbial translocation was assessed by plasma levels of lipopolysaccharide (LPS). A larger proportion of untreated individuals compared with treated individuals had D-dimer above normal reference range (27.7 vs. 2.2%, P = 0.001). In both treated and untreated individuals, delayed clot initiation with TEG R-time above upper reference range (18 and 28%, respectively, both P 
ISSN:0269-9370
1473-5571
DOI:10.1097/01.aids.0000432462.21723.ed