Nkambule B B, Davison G M, Ipp H
Division of Haematology, Department of Pathology, Stellenbosch University and NHLS, Tygerberg, South Africa.
Department of Biomedical sciences, Faculty of Health and wellness sciences, Cape Peninsula University of Technology, Bellville, South Africa.
Int J Lab Hematol. 2015 Aug;37(4):450-8. doi: 10.1111/ijlh.12307. Epub 2014 Nov 17.
Cardiovascular disease and thrombotic events have emerged as major causes of mortality in people living with HIV. Activated platelets play a key role in both inflammation and thrombosis. Haematology analysers measure a variety of platelet indices, which could be surrogate markers of platelet activation. Flow cytometry offers the discrimination of platelet subpopulations and evaluation of the activation status of platelets. This study aimed to measure platelet indices in untreated HIV infection and to evaluate their relationship with markers of immune activation and disease progression.
One hundred and eighty-five antiretroviral therapy (ART)-naïve HIV-infected and 145 HIV-negative healthy individuals were recruited. Platelet indices measured using the ADVIA 2120 platform consisted of platelet count (PLT ×10(9) /L), mean platelet volume (MPV fL), platelet distribution width (PDW%) and plateletcrit (PCT%). These were correlated with CD4 count, %CD38 on CD8+ (CD38/8) T cells, viral load, fibrinogen, D-dimers and CD31+ platelet CD62P and CD36 expression, determined using flow cytometry.
The HIV group had decreased MPV levels [median 7.7 (7.1-8.3) vs. control group 8.4 (7.8-9.2), P < 0.0001], which correlated with PCT% (r = 0.3038, P = 0.0013), viral load (r = 0.2680, P = 0.0177) and PDW% (r = 0.2479, P = 0.0257). Additionally, the MPV correlated with CD4 count r = -0.2898, P = 0.0075. The HIV group had decreased PDW%, 49.35 (46.40-52.65) vs. control group, 53.90 (50-56.80), P = 0.0170. In addition, the PDW% showed correlations with D-dimers (r = 0.443, P = 0.03) and %CD36 (r = -0.3666, P = 0.0463).
Platelet indices may offer a rapid and affordable method for monitoring platelet activation and disease progression in patients with HIV.
心血管疾病和血栓形成事件已成为艾滋病毒感染者死亡的主要原因。活化血小板在炎症和血栓形成中均起关键作用。血液分析仪可测量多种血小板指标，这些指标可能是血小板活化的替代标志物。流式细胞术可区分血小板亚群并评估血小板的活化状态。本研究旨在测量未经治疗的艾滋病毒感染者的血小板指标，并评估它们与免疫活化和疾病进展标志物之间的关系。
招募了185名未接受抗逆转录病毒治疗（ART）的艾滋病毒感染者和145名艾滋病毒阴性的健康个体。使用ADVIA 2120平台测量的血小板指标包括血小板计数（PLT×10⁹/L）、平均血小板体积（MPV fL）、血小板分布宽度（PDW%）和血小板压积（PCT%）。这些指标与通过流式细胞术测定的CD4细胞计数、CD8⁺（CD38/8）T细胞上的CD38%、病毒载量、纤维蛋白原、D-二聚体以及CD31⁺血小板CD62P和CD36表达相关。
艾滋病毒感染组的MPV水平降低[中位数7.7（7.1 - 8.3），对照组为8.4（7.8 - 9.2），P < 0.0001]，其与PCT%（r = 0.3038，P = 0.0013）、病毒载量（r = 0.2680，P = 0.0177）和PDW%（r = 0.2479，P = 0.0257）相关。此外，MPV与CD4细胞计数相关，r = -0.2898，P = 0.0075。艾滋病毒感染组的PDW%降低，为49.35（46.40 - 52.65），对照组为53.90（50 - 56.80），P = 0.0170。此外，PDW%与D-二聚体（r = 0.443，P = 0.03）和CD36%（r = -0.3666，P = 0.0463）相关。
血小板指标可能为监测艾滋病毒患者的血小板活化和疾病进展提供一种快速且经济实惠的方法。
