Related Experiment Videos
Correlation of antiphospholipid antibodies and protein S deficiency with thrombosis in HIV-infected men
K L Hassell1, D C Kressin, A Neumann
1Department of Medicine, Denver VA Medical Center, CO 80220.
Abstract:
Antiphospholipid antibodies (aPL) and free protein S (PSF) deficiency have been associated with clinical thrombosis. Previous reports described a high prevalence of these abnormalities in HIV-infected individuals, but suggested there was little associated clinical thrombosis. A cohort of 74 HIV-infected men were studied for aPL, PSF deficiency and the development of thrombosis. aPL, predominantly anticardiolipin antibodies (aCL), were detected in 86% and PSF deficiency in 33%. While 42% of men with aPL also had low PSF levels, there was no correlation between aCL titres or most measures of aPL and PSF levels. However, a strong correlation was noted between a subset of aPL that reacted to phosphatidylethanolamine by hexagonal array assay and low PSF levels. There was no significant correlation between aPL, PSF deficiency and clinical features (medication use, opportunistic infection, CD4 cell count) of HIV in 60 patients for whom clinical information was available. The overall incidence of thrombosis in this group was 18%, and thrombosis developed in 6.6% of those followed prospectively over a median follow-up of 12 months. Development of thrombosis was not significantly correlated with aPL or PSF deficiency, but the high prevalence of these abnormalities may necessitate larger study groups to determine the risk associated with these coagulation changes. Study of a larger group with careful analysis of subsets of aPL, especially those associated with low PSF levels, and longer clinical follow-up could identify the HIV-infected individuals at risk for thrombosis.
Insights
Antiphospholipid antibodies (aPL) and free protein S (PSF) deficiency are common in HIV-infected men. While these coagulation abnormalities were prevalent, they did not significantly correlate with thrombosis in this study group.
Area of Science:
- Hematology
- Immunology
- Infectious Diseases
Background:
- Antiphospholipid antibodies (aPL) and free protein S (PSF) deficiency are linked to thrombosis.
- Previous studies indicated a high prevalence of these abnormalities in HIV-infected individuals, with limited associated thrombosis.
- This study investigates the relationship between aPL, PSF deficiency, and thrombosis in HIV-infected men.
Purpose of the Study:
- To determine the prevalence of aPL and PSF deficiency in HIV-infected men.
- To assess the association between aPL, PSF deficiency, and the development of clinical thrombosis.
- To explore correlations between these coagulation abnormalities and clinical features of HIV infection.
Main Methods:
- A cohort of 74 HIV-infected men were analyzed for aPL and PSF deficiency.
- Clinical data, including medication use, opportunistic infections, and CD4 cell counts, were collected.
- Prospective follow-up was conducted to monitor the incidence of thrombosis over a median of 12 months.
Main Results:
- aPL were detected in 86% and PSF deficiency in 33% of participants.
- A strong correlation was found between a specific subset of aPL (reacting to phosphatidylethanolamine) and low PSF levels.
- No significant correlation was observed between aPL, PSF deficiency, and clinical HIV features or the development of thrombosis.
Conclusions:
- High prevalence of aPL and PSF deficiency exists in HIV-infected men, but their direct correlation with thrombosis requires further investigation.
- Specific aPL subsets, particularly those associated with low PSF levels, may warrant closer examination in larger cohorts.
- Larger studies with extended follow-up are needed to clarify the thrombotic risk associated with these coagulation abnormalities in HIV-infected individuals.