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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

Correlation analysis of sCD14 vs LPS (log-transformed) (A), sCD14 vs LBP (B), LBP vs LPS (log-transformed) (C), vWF vs sCD14 (D), vWF vs LBP (E) and vWF vs LPS (log-transformed) (F). A Spearman's Rank-order test was used for analysis. Only sCD14 and LPS (log-transformed) had a statistically significant correlation (A). There was a weak trend toward positive correlation between vWF and sCD14 (D). LPS, Lipopolysaccharide; LBP, LPS binding protein; sCD14, soluble CD14; vWF, von Willebrand Factor antigen level.
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Figure 5: Correlation analysis of sCD14 vs LPS (log-transformed) (A), sCD14 vs LBP (B), LBP vs LPS (log-transformed) (C), vWF vs sCD14 (D), vWF vs LBP (E) and vWF vs LPS (log-transformed) (F). A Spearman's Rank-order test was used for analysis. Only sCD14 and LPS (log-transformed) had a statistically significant correlation (A). There was a weak trend toward positive correlation between vWF and sCD14 (D). LPS, Lipopolysaccharide; LBP, LPS binding protein; sCD14, soluble CD14; vWF, von Willebrand Factor antigen level.

Mentions: The only association detected was a positive correlation between levels of soluble CD14 and log 10 levels of LPS (p = 0.003; r = 0.255, Figure 5A). There was also a weak trend toward positive correlation between plasma levels of vWF and sCD14 (p = 0.078; r = 0.184, Figure 5D). The four other combinations of markers (vWF vs. LBP; vWF vs. log 10 LPS; sCD14 vs. LBP; LBP vs. log 10 LPS) were not correlated (all p > 0.1) (Figures 5B,C,E,F).


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)

Correlation analysis of sCD14 vs LPS (log-transformed) (A), sCD14 vs LBP (B), LBP vs LPS (log-transformed) (C), vWF vs sCD14 (D), vWF vs LBP (E) and vWF vs LPS (log-transformed) (F). A Spearman's Rank-order test was used for analysis. Only sCD14 and LPS (log-transformed) had a statistically significant correlation (A). There was a weak trend toward positive correlation between vWF and sCD14 (D). LPS, Lipopolysaccharide; LBP, LPS binding protein; sCD14, soluble CD14; vWF, von Willebrand Factor antigen level.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 5: Correlation analysis of sCD14 vs LPS (log-transformed) (A), sCD14 vs LBP (B), LBP vs LPS (log-transformed) (C), vWF vs sCD14 (D), vWF vs LBP (E) and vWF vs LPS (log-transformed) (F). A Spearman's Rank-order test was used for analysis. Only sCD14 and LPS (log-transformed) had a statistically significant correlation (A). There was a weak trend toward positive correlation between vWF and sCD14 (D). LPS, Lipopolysaccharide; LBP, LPS binding protein; sCD14, soluble CD14; vWF, von Willebrand Factor antigen level.
Mentions: The only association detected was a positive correlation between levels of soluble CD14 and log 10 levels of LPS (p = 0.003; r = 0.255, Figure 5A). There was also a weak trend toward positive correlation between plasma levels of vWF and sCD14 (p = 0.078; r = 0.184, Figure 5D). The four other combinations of markers (vWF vs. LBP; vWF vs. log 10 LPS; sCD14 vs. LBP; LBP vs. log 10 LPS) were not correlated (all p > 0.1) (Figures 5B,C,E,F).

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