Akinosoglou Karolina, Kolosaka Martha, Schinas George, Delastic Anne-Lise, Antonopoulou Stefania, Perperis Angelos, Marangos Markos, Mouzaki Athanasia, Gogos Charalambos
Department of Internal Medicine, University General Hospital of Patras, 26504 Patras, Greece.
Medical School, University of Patras, 26504 Patras, Greece.
Microorganisms. 2023 Apr 6;11(4):958. doi: 10.3390/microorganisms11040958.
People living with HIV (PLWHIV) present an increased risk of adverse cardiovascular events. We aimed to assess whether antiretroviral therapy (ART) pharmacologically enhances platelet reactivity and platelet activation intensity, and explore the potential association with underlying inflammatory status. This was a cross-sectional cohort study carried out among PLWHIV on diverse ART regimens. Platelet reactivity and activation intensity were assessed using the bedside point-of-care VerifyNow assay, in P2Y12 reaction units (PRU), measurements of monocyte-platelet complexes, and P-selectin and GPIIb/IIIa expression increase, following activation with ADP, respectively. Levels of major inflammatory markers and whole blood parameters were also evaluated. In total, 71 PLWHIV, 59 on ART and 22 healthy controls, were included in this study. PRU values were significantly elevated in PLWHIV compared to controls [Mean; 257.85 vs. 196.67, < 0.0001], but no significant differences were noted between ART-naïve or ART-experienced PLWHIV, or between TAF/TDF and ABC based regimens, similar to systemic inflammatory response. However, within-group analysis showed that PRUs were significantly higher in ABC/PI vs ABC/INSTI or TAF/TDF + PI patients, in line with levels of IL-2. PRU values did not correlate strongly with CD4 counts, viral load, or cytokine values. P-selectin and GPIIb/IIIa expression increased following ADP activation and were significantly more prominent in PLWHIV ( < 0.005). Platelet reactivity and platelet activation intensity were shown to be increased in PLWHIV, but they did not appear to be related to ART initiation, similar to the underlying systemic inflammatory response.
感染人类免疫缺陷病毒（HIV）的人群（PLWHIV）发生不良心血管事件的风险增加。我们旨在评估抗逆转录病毒疗法（ART）是否在药理学上增强血小板反应性和血小板活化强度，并探讨其与潜在炎症状态的潜在关联。这是一项针对接受不同ART方案的PLWHIV进行的横断面队列研究。使用床旁即时检验VerifyNow检测法评估血小板反应性和活化强度，以P2Y12反应单位（PRU）表示，分别测量单核细胞-血小板复合物以及用ADP激活后P-选择素和糖蛋白IIb/IIIa表达的增加情况。还评估了主要炎症标志物水平和全血参数。本研究共纳入71例PLWHIV，其中59例接受ART治疗，22例为健康对照。与对照组相比，PLWHIV的PRU值显著升高[平均值；257.85对196.67，<0.0001]，但在未接受过ART治疗或有ART治疗经验的PLWHIV之间，以及基于替诺福韦艾拉酚胺/替诺福韦酯（TAF/TDF）和阿巴卡韦（ABC）的方案之间，未观察到显著差异，这与全身炎症反应情况类似。然而，组内分析显示，与ABC/整合酶链转移抑制剂（INSTI）或TAF/TDF + 蛋白酶抑制剂（PI）患者相比，ABC/PI患者的PRU值显著更高，这与白细胞介素-2水平一致。PRU值与CD4细胞计数、病毒载量或细胞因子值无强相关性。ADP激活后P-选择素和糖蛋白IIb/IIIa表达增加，且在PLWHIV中显著更明显（<0.005）。结果表明PLWHIV的血小板反应性和血小板活化强度增加，但它们似乎与开始ART治疗无关，这与潜在的全身炎症反应情况类似。
