Derigubah Charles A, Nkansah Charles, Mensah Kofi, Appiah Samuel K, Osei-Boakye Felix, Odame Enoch, Owusu Michael, Serwaa Dorcas, Hubert Maxwell A, Bani Simon Bannison, Kuugbee Eugene, Issahaku Razak G, Debrah Alexander Y, Addai-Mensah Otchere
Department of Medical Laboratory Technology School of Applied Science and Arts, Bolgatanga Technical University Bolgatanga Ghana.
Department of Medical Diagnostics Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology Kumasi Ghana.
Health Sci Rep. 2023 Jul 21;6(7):e1436. doi: 10.1002/hsr2.1436. eCollection 2023 Jul.
Impaired coagulation and fibrinolysis have been implicated in thromboembolism in human immunodeficiency virus (HIV)-infected individuals. This study evaluated the plasma levels of plasminogen activator inhibitor-1 (PAI-1) and coagulation biomarkers in HIV-infected individuals on highly active antiretroviral therapy (HAART).
This matched case-control study from March to December, 2020 comprised 76 participants: 38 HIV-positive individuals on HAART and 38 apparently healthy HIV-negative individuals as controls. Blood samples were collected for prothrombin time (PT), activated partial thromboplastin time (aPTT), D-dimers, PAI-1, and soluble fibrin monomer complex (SFMC) estimations. The data were analysed using SPSS version 22.0 and statistical significance was set at < 0.05.
Activated partial thromboplastin time was significantly lower in HIV seropositive individuals on HAART compared with HIV seronegative controls (25.90 s vs. 29.0 s, = 0.030); however, PT, SFMC, D-dimers, and PAI-1 were significantly higher among the HIV-seropositive individuals compared with the controls: PT: (16.29 s ± 2.16 vs. 15.15 s ± 2.60, = 0.010), SFMC: [8.53 ng/mL (8.03-9.12) vs. 7.84 ng/mL (7.32-8.58), = 0.005]), D-Dimer: [463.37 ng/mL (402.70-526.33) vs. 421.11 ng/mL (341.11-462.52), = 0.015], and PAI-1: [12.77 ng/mL (10.63-14.65) vs. 11.27 ng/mL (10.08-12.95), = 0.039]. PAI-1 showed a moderate positive correlation with D-Dimer ( = 0.659, < 0.001) and SFMC ( = 0.463, = 0.003) among HIV-positive individuals on HAART. There was a strong positive correlation between the plasma PAI-1 concentration and the HIV viral load ( = 0.955, < 0.001).
HIV-seropositive individuals on HAART have deranged coagulation and fibrinolytic markers. Higher HIV viral load correlates strongly with elevated plasma levels of PAI-1 antigens. Periodic assessment of markers of coagulation and fibrinolysis be included in the management of HIV/AIDS in Ghana.
凝血和纤维蛋白溶解功能受损与人类免疫缺陷病毒（HIV）感染个体的血栓栓塞有关。本研究评估了接受高效抗逆转录病毒治疗（HAART）的HIV感染个体的血浆纤溶酶原激活物抑制剂-1（PAI-1）水平及凝血生物标志物。
这项匹配病例对照研究于2020年3月至12月进行，共有76名参与者：38名接受HAART的HIV阳性个体和38名明显健康的HIV阴性个体作为对照。采集血样以测定凝血酶原时间（PT）、活化部分凝血活酶时间（aPTT）、D-二聚体、PAI-1和可溶性纤维蛋白单体复合物（SFMC）。使用SPSS 22.0版软件对数据进行分析，设定统计学显著性为<0.05。
接受HAART的HIV血清阳性个体的活化部分凝血活酶时间显著低于HIV血清阴性对照（25.90秒对29.0秒，P = 0.030）；然而，与对照组相比，HIV血清阳性个体的PT、SFMC、D-二聚体和PAI-1显著更高：PT：（16.29秒±2.16对15.15秒±2.60，P = 0.010），SFMC：[8.53纳克/毫升（8.03 - 9.12）对7.84纳克/毫升（7.32 - 8.58），P = 0.005]，D-二聚体：[463.37纳克/毫升（402.70 - 526.33）对421.11纳克/毫升（341.11 - 462.52），P = 0.015]，PAI-1：[12.77纳克/毫升（10.63 - 14.65）对11.27纳克/毫升（10.08 - 12.95），P = 0.039]。在接受HAART的HIV阳性个体中，PAI-1与D-二聚体（P = 0.659，P < 0.001）和SFMC（P = 0.463，P = 0.003）呈中度正相关。血浆PAI-1浓度与HIV病毒载量之间存在强正相关（P = 0.955，P < 0.001）。
接受HAART的HIV血清阳性个体存在凝血和纤维蛋白溶解标志物紊乱。较高的HIV病毒载量与血浆PAI-1抗原水平升高密切相关。加纳的HIV/AIDS管理中应包括对凝血和纤维蛋白溶解标志物的定期评估。
