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Comparison of pathological clotting using haematological, functional and morphological investigations in HIV-positive and HIV-negative patients with deep vein thrombosis.
Retrovirology. 2020 06 22; 17(1):14.R

Abstract

BACKGROUND

Patients infected with the human immunodeficiency virus (HIV) are more prone to systemic inflammation and pathological clotting, and many may develop deep vein thrombosis (DVT) as a result of this dysregulated inflammatory profile. Coagulation tests are not routinely performed unless there is a specific reason.

METHODS

We recruited ten healthy control subjects, 35 HIV negative patients with deep vein thrombosis (HIV negative-DVT), and 13 HIV patients with DVT (HIV positive-DVT) on the primary antiretroviral therapy (ARV) regimen-emtricitabine, tenofovir and efavirenz. Serum inflammatory markers, haematological results, viscoelastic properties using thromboelastography (TEG) and scanning electron microscopy (SEM) of whole blood (WB) were used to compare the groups.

RESULTS

The DVT patients (HIV positive and HIV negative) had raised inflammatory markers. The HIV positive-DVT group had anaemia in keeping with anaemia of chronic disorders. DVT patients had a hypercoagulable profile on the TEG but no significant difference between HIV negative-DVT and HIV positive-DVT groups. The TEG analysis compared well and supported our ultrastructural results. Scanning electron microscopy of DVT patient's red blood cells (RBCs) and platelets demonstrated inflammatory changes including abnormal cell shapes, irregular membranes and microparticle formation. All the ultrastructural changes were more prominent in the HIV positive-DVT patients.

CONCLUSIONS

Although there were trends that HIV-positive patients were more hypercoagulable on functional tests (viscoelastic profile) compared to HIV-negative patients, there were no significant differences between the 2 groups. The sample size was, however, small in number. Morphologically there were inflammatory changes in patients with DVT. These ultrastructural changes, specifically with regard to platelets, appear more pronounced in HIV-positive patients which may contribute to increased risk for hypercoagulability and deep vein thrombosis.

Authors+Show Affiliations

Department of Surgery, University of Pretoria, Pretoria, 0007, South Africa.Department of Physiology, University of Pretoria, Pretoria, 0007, South Africa.Department of Physiological Sciences, Stellenbosch University, Stellenbosch, Private Bag X1 Matieland, 7602, South Africa. resiap@sun.ac.za.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32571345

Citation

Jackson, Brandon S., et al. "Comparison of Pathological Clotting Using Haematological, Functional and Morphological Investigations in HIV-positive and HIV-negative Patients With Deep Vein Thrombosis." Retrovirology, vol. 17, no. 1, 2020, p. 14.
Jackson BS, Nunes Goncalves J, Pretorius E. Comparison of pathological clotting using haematological, functional and morphological investigations in HIV-positive and HIV-negative patients with deep vein thrombosis. Retrovirology. 2020;17(1):14.
Jackson, B. S., Nunes Goncalves, J., & Pretorius, E. (2020). Comparison of pathological clotting using haematological, functional and morphological investigations in HIV-positive and HIV-negative patients with deep vein thrombosis. Retrovirology, 17(1), 14. https://doi.org/10.1186/s12977-020-00523-3
Jackson BS, Nunes Goncalves J, Pretorius E. Comparison of Pathological Clotting Using Haematological, Functional and Morphological Investigations in HIV-positive and HIV-negative Patients With Deep Vein Thrombosis. Retrovirology. 2020 06 22;17(1):14. PubMed PMID: 32571345.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of pathological clotting using haematological, functional and morphological investigations in HIV-positive and HIV-negative patients with deep vein thrombosis. AU - Jackson,Brandon S, AU - Nunes Goncalves,Julien, AU - Pretorius,Etheresia, Y1 - 2020/06/22/ PY - 2019/11/11/received PY - 2020/06/16/accepted PY - 2020/6/24/entrez PY - 2020/6/24/pubmed PY - 2020/6/24/medline KW - Deep vein thrombosis (DVT) KW - Human immunodeficiency virus (HIV) KW - Hypercoagulability KW - Inflammation SP - 14 EP - 14 JF - Retrovirology JO - Retrovirology VL - 17 IS - 1 N2 - BACKGROUND: Patients infected with the human immunodeficiency virus (HIV) are more prone to systemic inflammation and pathological clotting, and many may develop deep vein thrombosis (DVT) as a result of this dysregulated inflammatory profile. Coagulation tests are not routinely performed unless there is a specific reason. METHODS: We recruited ten healthy control subjects, 35 HIV negative patients with deep vein thrombosis (HIV negative-DVT), and 13 HIV patients with DVT (HIV positive-DVT) on the primary antiretroviral therapy (ARV) regimen-emtricitabine, tenofovir and efavirenz. Serum inflammatory markers, haematological results, viscoelastic properties using thromboelastography (TEG) and scanning electron microscopy (SEM) of whole blood (WB) were used to compare the groups. RESULTS: The DVT patients (HIV positive and HIV negative) had raised inflammatory markers. The HIV positive-DVT group had anaemia in keeping with anaemia of chronic disorders. DVT patients had a hypercoagulable profile on the TEG but no significant difference between HIV negative-DVT and HIV positive-DVT groups. The TEG analysis compared well and supported our ultrastructural results. Scanning electron microscopy of DVT patient's red blood cells (RBCs) and platelets demonstrated inflammatory changes including abnormal cell shapes, irregular membranes and microparticle formation. All the ultrastructural changes were more prominent in the HIV positive-DVT patients. CONCLUSIONS: Although there were trends that HIV-positive patients were more hypercoagulable on functional tests (viscoelastic profile) compared to HIV-negative patients, there were no significant differences between the 2 groups. The sample size was, however, small in number. Morphologically there were inflammatory changes in patients with DVT. These ultrastructural changes, specifically with regard to platelets, appear more pronounced in HIV-positive patients which may contribute to increased risk for hypercoagulability and deep vein thrombosis. SN - 1742-4690 UR - https://www.unboundmedicine.com/medline/citation/32571345/Comparison_of_pathological_clotting_using_haematological,_functional_and_morphological_investigations_in_HIV-positive_and_HIV-negative_patients_with_deep_vein_thrombosis L2 - https://retrovirology.biomedcentral.com/articles/10.1186/s12977-020-00523-3 DB - PRIME DP - Unbound Medicine ER -
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