Pattern of deranged haemostatic biomarkers among HIV patients: a descriptive case control cohort study in a tertiary health facility in northeastern Nigeria

Abstract

HIV infection is known to affect haematological profile through various mechanisms; direct effect of the virus on haemopoiesis, natural anticoagulants and vasculopathy. In this study, we determine the pattern of derangement of some haemeostatic biomarkers among HIV cohort with Mild disease (WHO clinical stage I or II), those with moderate to advanced disease WHO clinical stages III and IV, and apparently health HIV sero negative participants. Parameters considered includes Platelet count (PLT), Prothrombin time (PT), Activated partial thromboplatin time (APTT), Antithrombin (AT), Protein C (PC), Protein S (PS) and Lupus anticoagulant (LA). A total of 750 participants made up of 249 with mild HIV infection in WHO clinical stages I and II , 250 with moderate to severe disease in stages III and IV were considered as cases and 251 HIV negative control subjects. A total of 262 (52.5%) HIV patients had derangement of one or the other of coagulation biomarkers considered. Prolonged LA ratio was more common among those with moderate to severe disease with prevalence rate of 39 (7.8%) in comparison to 5(1.0%) in those with mild disease. CD4 count < 200 cells were overtly associated with prolonged LA ratio. HIV patients with clinical AIDS such as CD4 cell count = 200cells/ul are less likely to develop deranged LA, AT, PC and PS compared to those with CD4 cell count <200 cells/ul (immunological AIDS). Deranged activity of haemostatic biomarkes is common among HIV infected patients, especially among those with immunological AIDS. Low CD4 cell count < 200 cells/ul is a predictor of haemostatic abnormalities in this category of patients.

Keywords: HIV Protein C, Protein S, Antithrombin III , PC = Protein C, Lupus anticoagulant