Skip Navigation LinksHome > March 27, 2011 - Volume 25 - Issue 6 > Markers of endothelial dysfunction, coagulation and tissue f...
doi: 10.1097/QAD.0b013e3283453fcb
Clinical Science

Markers of endothelial dysfunction, coagulation and tissue fibrosis independently predict venous thromboembolism in HIV

Musselwhite, Laura Wa; Sheikh, Virginiaa; Norton, Thomas Da; Rupert, Adamb; Porter, Brian Oa; Penzak, Scott Ra; Skinner, Jeffa; Mican, JoAnn Ma; Hadigan, Colleena; Sereti, Irinia

Collapse Box


Objective: HIV infection is associated with coagulation abnormalities and significantly increased risk of venous thrombosis. It has been shown that higher plasma levels of coagulation and inflammatory biomarkers predicted mortality in HIV. We investigated the relationship between venous thrombosis and HIV-related characteristics, traditional risk factors of hypercoagulability, and pre-event levels of biomarkers.

Design: A retrospective case–control study of 23 HIV-infected individuals who experienced an incident venous thromboembolic event while enrolled in National Institutes of Health studies from 1995 to 2010 and 69 age-matched and sex-matched HIV-infected individuals without known venous thromboembolism (VTE).

Methods: Biomarkers of inflammation, endothelial dysfunction, coagulation, tissue fibrosis, and cytomegalovirus (CMV) reactivation were assessed by ELISA-based assays and PCR using plasma obtained prior to the event.

Results: VTE events were related to nadir CD4 cell count, lifetime history of multiple opportunistic infections, CMV disease, CMV viremia, immunological AIDS, active infection, and provocation (i.e., recent hospitalization, surgery, or trauma). VTE events were independently associated with increased plasma levels of P-selectin (P = 0.002), D-dimer (P = 0.01), and hyaluronic acid (P = 0.009) in a multivariate analysis. No significant differences in antiretroviral or interleukin-2 exposures, plasma HIV viremia, or other traditional risk factors were observed.

Conclusion: Severe immunodeficiency, active infection, and provocation are associated with venous thromboembolic disease in HIV. Biomarkers of endothelial dysfunction, coagulation, and tissue fibrosis may help identify HIV-infected patients at elevated risk of VTE.

© 2011 Lippincott Williams & Wilkins, Inc.


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.