MERCIER R, WRIGHT H, NADEAU L, NAKANO L, AREPALLY G, KOSTER F; Interscience Conference on Antimicrobial Agents and Chemotherapy (42nd : 2002 : San Diego, Calif.).

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2002 Sep 27-30; 42: abstract no. H-1937.

University of New Mexico - Health Sciences Center, Albuquerque, NM.

BACKGROUND: Individuals infected with HIV are reported to have a higher incidence of coagulation abnormalities compared to non-HIV infected patients. Reports have described protein S deficiency in HIV infected individuals, which has been associated with thrombosis. We studied whether the addition of PIs to antiretroviral therapy in non-hemophiliac HIV-infected individuals leads to coagulation factor abnormalities. METHODS: Patients initiating a PI-containing regimen were enrolled in a prospective, sequential control study. Blood was obtained prior to initiating the PI (hour 0) and at hours 7, 24, 72, and 1 month following initiation of therapy. Fibrinogen, PT, PTT, TT, proteins C and S, antithrombin III (AT3), and antiphospholipid antibodies were measured. Percent change over time for the different markers of coagulation was analyzed using ANOVA. RESULTS: Twenty-five patients were enrolled, 22 completed the study and 3 were lost to followup. Patient characteristics were as follows prior to initiating PI(s): mean age 37 yrs [22-58], 21 males, 1 female, mean CD4 count 136 cells/mm[3] [1-599], mean HIV RNA level 2.3 x 10[5] copies/ml [1.8 x 10[3] -7.5 x 10[5]]. Mean increases in protein C and S, and AT3 were significantly higher at the 1-month followup compared to baseline (P<0.05). Mean decrease in TT was shorter after 1 month of PI therapy compared to baseline (P<0.05). Initiation of a PI did not significantly alter the fibrinogen level, PT, PTT, and INR (P>0.05). CONCLUSIONS: Contrary to published reports, we have found that PIs are associated with an increase in circulating anticoagulants 1-month after initiating therapy. However the TT also shortened over that same period suggesting a prothrombotic effect that has yet to be characterized. Further studies are warranted to establish the exact mechanism(s) by which PIs affect the coagulation cascade.

Publication Types:

• Meeting Abstracts

Keywords:

• AIDS Vaccines
• Acquired Immunodeficiency Syndrome
• Anti-HIV Agents
• CD4 Lymphocyte Count
• Disease Progression
• Female
• HIV
• HIV Infections
• HIV Protease
• HIV Seropositivity
• Hemophilia A
• Humans
• Male
• Prospective Studies
• Protease Inhibitors

Other ID:

• GWAIDS0027761

UI: 102267385

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