Nigerian Journal of Physiological Sciences. Vol 34, No 1 (2019):99-105

D-dimer as a predictor of altered coagulation in HIV patients in Nigeria
F.A. Aisabokhale, T.S. Akingbola, K Bamidele

Summary: Recent medical advances have improved the quality of life and correspondingly reduced the morbidity and mortality associated with HIV infection. However increased life expectancy has led to a relative rise in comorbidities and complications such as alterations in coagulation systems. This study is aimed at the evaluation of D-dimer level as a predictor of thromboembolic risk in HIV patients. A total of 152 HIV positive and negative subjects and control respectively attending the PEPFAR clinic UCH in Ibadan were recruited both for a questionnaire-based survey and a coagulation profile screening. Activated Partial Thromboplastin Time (APTT), Prothrombin Time (PT), D-dimer level the viral load indices of the HIV patients and their CD4 counts were also evaluated. In the subjects, the D-dimer level was significantly higher (193.6 ?? 177.00ng/ml) than the controls (118.10 ?? 140.58ng/ml) while a significantly lower APTT was also reported (36.22 ?? 4.05 seconds) compared to the controls (41.14 ?? 8.87 seconds). An evaluation of the coagulation profile in the Highly Active Antiretroviral Therapy (HAART) naive and experienced group revealed only a significant difference (417.4 ?? 162.0 versus 268.2 ?? 193.5; p value 0.000) in the CD4 counts whilst no significant changes in the coagulation profile. In our study, a higher predisposition to a hypercoagulable state presenting as a short APTT was observed. This finding along with the higher D-dimer level underscores the relevance of the evaluation of this biomarker as an important predictor of thromboembolic event risk.Keywords: HIV, thrombotic event, D-dimer, altered coagulation profile, CD4 count, APTT, PT

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