Extrinsic and intrinsic coagulation pathway, fibrinogen serum level and platelet count in HIV positive patients

ABSTRACT

Infection with human immunodeficiency virus [HIV] is a progressive condition which may cause endothelial dysfunction and liver damage leading to coagulopathy. With adventure of highly active antiretroviral therapy [HAART], life expectancy has prolonged in HIV positive patients but several acquired immunodeficiency syndrome [AIDS]-related conditions such as coagulopathies are responsible for associated morbidity and mortality. This study aimed to evaluate the extrinsic and intrinsic pathways of coagulation, serum level of fibrinogen and platelet count in HIV positive patients and compare it with negative healthy individuals. Through a case-control study, 114 HIV seropositive patients were compared with 114 seronegative samples in terms of hematological and other coagulation parameters. Mean age of study patients was 37.48 years. Intra venous drug abuse was the most common route of infection transmission with a prevalence of more than 50%. HIV route of transmission had a direct relationship with PTT abnormal levels [P<0.0001]. However, this relationship was not significant for PT values. Stages of HIV disease and administration of HAART did not reveal any significant relationship with PT and PTT. There was also a statistically significant correlation between CD4[+]< 200 and PT in case group [P=0.008]. On the other hands, in control group, CD4[+] had a weak relationship with PTT [P=0.02] and an inverse correlation with serum fibrinogen [P=0.013]. Hematological parameters and serum fibrinogen are decreased in HIV positive patients especially in direct relation with CD4[+] cell count<200 cell/ micro l. PT and PTT abnormal values are also more prevalent in this population