HIV is associated with thrombophilia and high D-dimer in children and adolescents

Giuseppe Pontrelli, Alessandra M. Martino, Hyppolite K. Tchidjou, Rita Citton, Nadia Mora, Lucilla Ravà, Alberto E. Tozzi, Paolo Palma, Maurizio Muraca, Elisabetta Franco, Paolo Rossi, Stefania Bernardi

Research output: Contribution to journalArticlepeer-review

Abstract

Background and Objective: Atherosclerosis and other cardiovascular diseases associated with thrombosis appear more relevant and anticipated in HIV-infected patients after combination antiretroviral therapy (cART) has reduced AIDS-related diseases and has improved survival. The association between viral replication and coagulation abnormalities in a cohort of HIV-infected children and adolescents was investigated here. Methods: Protein S, protein C anticoagulant and antithrombin activity, together with fibrinogen, D-dimer, high-sensitive C-reactive protein and homocysteine were assayed in a cross-sectional study among a cohort of HIV-infected children and adolescents. Results in patients with high viral load (HVL, HIV-RNA > 1000 copies/ml) were compared with those in patients with a lower replication (LVL), adjusting for other demographic, clinical and therapeutic covariates. Results: Eighty-eight patients (mean age 13.5 years, CD4 30%, 72% with LVL) were enrolled. A prevalence of protein S and protein C deficiency of 51 and 8% was, respectively, found. HVL group compared to LVL showed a significant reduction of protein S, protein C and antithrombin activities, and an increase of D-dimer levels. The independent association of HVL with decreased protein S activity (-11.2%, P = 0.04) and increased D-dimer levels (+0.13 μg/ml, P = 0.004) was confirmed in the multivariate model. Conclusions: HIV-infected children and adolescents present high prevalence of thrombophilic abnormalities. The multivariate model confirmed that high viral replication is independently associated with decrease of protein S and increase of D-dimer, suggesting the advantage of suppressive therapy on coagulation homeostasis and the opportunity of an active control of cardiovascular risk factors starting at a younger age.

Original languageEnglish
Pages (from-to)1145-1151
Number of pages7
JournalAIDS (London, England)
Volume24
Issue number8
DOIs
Publication statusPublished - May 2010

Keywords

  • D-dimer
  • HIV
  • Paediatric
  • Protein S
  • Thrombophilia

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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