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von Willebrand Factor is elevated in HIV patients with a history of thrombosis.

van den Dries LW, Gruters RA, Hövels-van der Borden SB, Kruip MJ, de Maat MP, van Gorp EC, van der Ende ME - Front Microbiol (2015)

Bottom Line: Arterial and venous thrombotic events are more prevalent in HIV infected individuals compared to the general population, even in the era of combination antiretroviral therapy.The incidence of venous thrombosis was two-fold higher in HIV infected patients compared to age-adjusted data from general population cohort studies.This could be a reason to prolong anti-thrombotic treatment in HIV patients with a history of thrombosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, Netherlands.

ABSTRACT

Background: Arterial and venous thrombotic events are more prevalent in HIV infected individuals compared to the general population, even in the era of combination antiretroviral therapy. Although the mechanism is not fully understood, recent evidence suggests a role for chronic immune activation.

Methods: We reviewed the Dutch National HIV registry database for HIV infected patients in Rotterdam with a history of arterial or venous thrombosis and calculated the incidence. We collected samples from patients with and without thrombosis and compared plasma levels of lipopolysaccharide (LPS), LPS binding protein (LBP), soluble CD14 (sCD14), and von Willebrand Factor antigen level (vWF).

Results: During a 10-year period, a total of 60 documented events in 14,026 person years of observation (PYO) occurred, resulting in an incidence rate of 2.50, 2.21, and 4.28 for arterial, venous and combined thrombotic events per 1000 PYO, respectively. The vWF was elevated in the majority of study subjects (mean 2.36 SD ± 0.88 IU/ml); we found a significant difference when comparing venous cases to controls (mean 2.68 SD ± 0.82 IU/ml vs. 2.20 SD ± 0.77 IU/ml; p = 0.024). This difference remained significant for recurrent events (mean 2.78 SD ± 0.75; p = 0.043). sCD14 was positively correlated with LPS (r = 0.255; p = 0.003).

Conclusion: The incidence of venous thrombosis was two-fold higher in HIV infected patients compared to age-adjusted data from general population cohort studies. We couldn't find a clear association between immune activation markers to either arterial or venous thrombotic events. We observed a marked increase in vWF levels as well as a correlation of vWF to first and recurrent venous thrombo-embolic events. These findings suggest that HIV infection is an independent risk factor for coagulation abnormalities and could contribute to the observed high incidence in venous thrombosis. This could be a reason to prolong anti-thrombotic treatment in HIV patients with a history of thrombosis.

No MeSH data available.


Related in: MedlinePlus

Flow chart depicting the selection of patients for this study.
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Figure 1: Flow chart depicting the selection of patients for this study.

Mentions: At the time of inclusion on February 25th 2013, a total of 1679 HIV-infected patients were still in care out of which 79 were reported with a thrombotic event (see Figure 1). Of these 79 patients, 10 patients were excluded based on a negative HIV test at the time of event and 4 patients refused participation, resulting in 65 available cases. In addition, we searched the database for patients that died between April 1st 2002 and November 22nd 2012 and had a history of thrombosis. In total, 223 patients died during this period of which 20 had a documented thrombotic event in the past. Of these 85 patients, 37 were diagnosed with a PE or DVT; 41 with a MI, CVA or CI; and 7 had endured both a venous and arterial event.


von Willebrand Factor is elevated in HIV patients with a history of thrombosis.

van den Dries LW, Gruters RA, Hövels-van der Borden SB, Kruip MJ, de Maat MP, van Gorp EC, van der Ende ME - Front Microbiol (2015)

Flow chart depicting the selection of patients for this study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4356086&req=5

Figure 1: Flow chart depicting the selection of patients for this study.
Mentions: At the time of inclusion on February 25th 2013, a total of 1679 HIV-infected patients were still in care out of which 79 were reported with a thrombotic event (see Figure 1). Of these 79 patients, 10 patients were excluded based on a negative HIV test at the time of event and 4 patients refused participation, resulting in 65 available cases. In addition, we searched the database for patients that died between April 1st 2002 and November 22nd 2012 and had a history of thrombosis. In total, 223 patients died during this period of which 20 had a documented thrombotic event in the past. Of these 85 patients, 37 were diagnosed with a PE or DVT; 41 with a MI, CVA or CI; and 7 had endured both a venous and arterial event.

Bottom Line: Arterial and venous thrombotic events are more prevalent in HIV infected individuals compared to the general population, even in the era of combination antiretroviral therapy.The incidence of venous thrombosis was two-fold higher in HIV infected patients compared to age-adjusted data from general population cohort studies.This could be a reason to prolong anti-thrombotic treatment in HIV patients with a history of thrombosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, Netherlands.

ABSTRACT

Background: Arterial and venous thrombotic events are more prevalent in HIV infected individuals compared to the general population, even in the era of combination antiretroviral therapy. Although the mechanism is not fully understood, recent evidence suggests a role for chronic immune activation.

Methods: We reviewed the Dutch National HIV registry database for HIV infected patients in Rotterdam with a history of arterial or venous thrombosis and calculated the incidence. We collected samples from patients with and without thrombosis and compared plasma levels of lipopolysaccharide (LPS), LPS binding protein (LBP), soluble CD14 (sCD14), and von Willebrand Factor antigen level (vWF).

Results: During a 10-year period, a total of 60 documented events in 14,026 person years of observation (PYO) occurred, resulting in an incidence rate of 2.50, 2.21, and 4.28 for arterial, venous and combined thrombotic events per 1000 PYO, respectively. The vWF was elevated in the majority of study subjects (mean 2.36 SD ± 0.88 IU/ml); we found a significant difference when comparing venous cases to controls (mean 2.68 SD ± 0.82 IU/ml vs. 2.20 SD ± 0.77 IU/ml; p = 0.024). This difference remained significant for recurrent events (mean 2.78 SD ± 0.75; p = 0.043). sCD14 was positively correlated with LPS (r = 0.255; p = 0.003).

Conclusion: The incidence of venous thrombosis was two-fold higher in HIV infected patients compared to age-adjusted data from general population cohort studies. We couldn't find a clear association between immune activation markers to either arterial or venous thrombotic events. We observed a marked increase in vWF levels as well as a correlation of vWF to first and recurrent venous thrombo-embolic events. These findings suggest that HIV infection is an independent risk factor for coagulation abnormalities and could contribute to the observed high incidence in venous thrombosis. This could be a reason to prolong anti-thrombotic treatment in HIV patients with a history of thrombosis.

No MeSH data available.


Related in: MedlinePlus