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

Giuseppe Pontrelli1, Alessandra M Martino, Hyppolite K Tchidjou

  • 1Department of Public Health,Ospedale Pediatrico Bambino Gesù, Rome, Italy. giuseppe.pontrelli@opbg.net

AIDS (London, England)
|February 20, 2010
PubMed

Insights

High viral replication in HIV-infected youth is linked to blood clotting problems. This suggests that controlling HIV viral load may improve coagulation and reduce cardiovascular risk in children.

Area of Science:

  • Pediatric Infectious Diseases
  • Hematology
  • Cardiovascular Health

Background:

  • Combination antiretroviral therapy (cART) has improved survival for HIV-infected individuals, shifting focus to non-AIDS comorbidities like cardiovascular disease.
  • Thrombosis and atherosclerosis are increasingly recognized as significant risks in HIV-infected patients, particularly with improved longevity.

Purpose of the Study:

  • To investigate the association between viral replication levels and coagulation abnormalities in children and adolescents with HIV.
  • To assess the prevalence of thrombophilic markers in this pediatric cohort.

Main Methods:

  • A cross-sectional study was conducted on HIV-infected children and adolescents.
  • Assayed protein S, protein C, antithrombin activity, fibrinogen, D-dimer, hs-CRP, and homocysteine.
  • Compared results between patients with high viral load (HVL) and low viral load (LVL), adjusting for covariates.

Main Results:

  • 51% had protein S deficiency and 8% had protein C deficiency.
  • The HVL group showed significantly reduced protein S, protein C, and antithrombin activities compared to the LVL group.
  • High viral load was independently associated with decreased protein S activity and increased D-dimer levels.

Conclusions:

  • HIV-infected children and adolescents exhibit a high prevalence of thrombophilic abnormalities.
  • High viral replication is an independent risk factor for decreased protein S and increased D-dimer.
  • Suppressive HIV therapy may benefit coagulation homeostasis, highlighting the need for early cardiovascular risk factor management.
Abstract

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