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1996-02-26
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Document 0155
DOCN M9620155
TI Thrombotic tendencies and correlation with clinical status in patients
infected with HIV.
DT 9602
AU Feffer SE; Fox RL; Orsen MM; Harjai KJ; Glatt AE; Department of
Medicine, Nassau County Medical Center, East; Meadow, NY 11554, USA.
SO South Med J. 1995 Nov;88(11):1126-30. Unique Identifier : AIDSLINE
MED/96049159
AB Previous publications have described thrombotic events with unclear
causes in individuals infected with the human immunodeficiency virus
(HIV). We stratified the cases of 52 individuals infected with HIV by
degree of immunosuppression and the presence of complicating illnesses.
Plasma from these individuals was screened for abnormalities that might
predispose to thromboses. We found statistically significant differences
between patients with CD4 counts < 200/mm3 and those whose CD4 counts
were > 400/mm3 in the following: d-dimers, functional protein C,
antigenic protein C, total protein S antigen, free protein S antigen,
C4b-binding protein (C4b-BP), and von Willebrand antigen (vWD). Free
protein S correlated inversely with C4b-BP; vWD directly with total
protein S; and protein C inversely with d-dimers. D-dimers were
significantly elevated only in immunosuppressed patients with
complicating neoplastic/inflammatory disease. We propose that low-grade
disseminated intravascular coagulopathy in severely immunosuppressed
individuals with HIV and infectious, inflammatory, or neoplastic
complications is responsible for depressed protein C, which, together
with elevations in total protein S and vWD (markers of endothelial
injury), indicates a thrombotic predisposition.
DE von Willebrand Factor/ANALYSIS Adult Antifibrinolytic Agents/BLOOD
AIDS-Related Opportunistic Infections/BLOOD/COMPLICATIONS CD4
Lymphocyte Count Disseminated Intravascular
Coagulation/BLOOD/COMPLICATIONS Female Fibrin Fibrinogen Degradation
Products/ANALYSIS Human HIV Infections/BLOOD/*COMPLICATIONS/IMMUNOLOGY
Immunocompromised Host Inflammation Male
Neoplasms/BLOOD/COMPLICATIONS Protein C/ANALYSIS Protein S/ANALYSIS
Risk Factors Thrombosis/BLOOD/*COMPLICATIONS JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).