Department of Internal Medicine, Cape Fear Valley Hospital, Fayetteville, NC, 28304, USA.
Department of Internal Medicine, Mery Hospital Joplin, Joplin, MO, 64804, USA.
F1000Res. 2020 Jun 15;9:610. doi: 10.12688/f1000research.24016.2. eCollection 2020.
Human immunodeficiency virus (HIV) infection is a known hypercoagulable state with venous thromboembolism with a high mortality rate compared to the general population. The homeostatic balance in HIV infected patients improves with treatment compared to those who are not. A decreased hypercoagulable state noted by low levels of Von Willebrand factor, factor VIII and d-dimer levels along with higher protein C and S activity in patients on treatment suggests that hypercoagulable state is partially correctable with highly active antiretroviral therapy. HIV with heart muscle involvement can present as myocarditis or as dilated cardiomyopathy with left or right ventricular dysfunction. Here we present a case of a 57-year-old man with a known history of HIV infection, noncompliant with medical therapy presenting with dilated cardiomyopathy with biventricular thrombi with reduced protein C, protein S, and Antithrombin III levels.
人类免疫缺陷病毒（HIV）感染是一种已知的高凝状态，与普通人群相比，静脉血栓栓塞的死亡率较高。与未接受治疗的患者相比，接受治疗的 HIV 感染患者的体内平衡得到改善。治疗后，von Willebrand 因子、因子 VIII 和 D-二聚体水平降低，蛋白 C 和 S 活性升高，提示 HIV 感染患者的高凝状态部分可以通过高效抗逆转录病毒治疗纠正。HIV 合并心肌受累可表现为心肌炎或扩张型心肌病，伴有左心室或右心室功能障碍。这里我们介绍了一例 57 岁男性，已知 HIV 感染史，不遵医嘱，表现为扩张型心肌病，双心室血栓形成，蛋白 C、蛋白 S 和抗凝血酶 III 水平降低。
