Plasma levels of fibrinolytic and coagulation biomarkers in HIV‐infected individuals on highly active antiretroviral therapy: A case‐control study in a Northern Ghanaian population

Abstract

AbstractBackground and AimImpaired 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).MethodsThis 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 p < 0.05.ResultsActivated partial thromboplastin time was significantly lower in HIV seropositive individuals on HAART compared with HIV seronegative controls (25.90 s vs. 29.0 s, p = 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, p = 0.010), SFMC: [8.53 ng/mL (8.03–9.12) vs. 7.84 ng/mL (7.32–8.58), p = 0.005]), D‐Dimer: [463.37 ng/mL (402.70–526.33) vs. 421.11 ng/mL (341.11–462.52), p = 0.015], and PAI‐1: [12.77 ng/mL (10.63–14.65) vs. 11.27 ng/mL (10.08–12.95), p = 0.039]. PAI‐1 showed a moderate positive correlation with D‐Dimer (r = 0.659, p < 0.001) and SFMC (r = 0.463, p = 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 (r = 0.955, p < 0.001).ConclusionHIV‐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.