Thrombosis and a hypercoagulable state in HIV-infected patients.
Human immunodeficiency virus infection is an illness with protean manifestations including hematological abnormalities. Thromboembolic complications in HIV-infected patients have been described. Recent literature describes an incidence ranging from 0.26% to 7.6%; higher incidence is seen in patients with active opportunistic infections or malignancy, and in patients with the acquired immunodeficiency syndrome. A variety of potential mechanisms have been proposed to account for the observed hypercoagulability in HIV-infected patients. These include the presence of antiphospholipid-anticardiolipin antibodies, decreased activities of natural anticoagulants (especially protein S), and increased platelet activation. Recent epidemiological studies emphasize the increased incidence of thromboembolic events including myocardial infarction in the HIV-infected population after the introduction of highly active antiretroviral therapy. The use of protease inhibitors in particular is implicated. A hypercoagulable state and especially thromboses are emerging as clinical issues in HIV-infected patients. Further studies are in order to more clearly delineate the pathophysiologic mechanism(s) of thromboses in HIV-infected patients.
Shen
Yu-Min P
YM
University of Texas Southwestern Medical Center at Dallas, 75390, USA.
Frenkel
Eugene P
EP
D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000276:immunology; D000925:Anticoagulants / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D001241:Aspirin / Q000627:therapeutic use; D015331:Cohort Studies; D015658:HIV Infections / Q000097:blood* / Q000188:drug therapy; D017320:HIV Protease Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D019469:Indinavir / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology; D015539:Platelet Activation; D018455:Protein S Deficiency / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013923:Thromboembolism / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D019851:Thrombophilia / Q000139:chemically induced / Q000188:drug therapy / Q000209:etiology*; D013927:Thrombosis / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control
D017152:Antibodies, Antiphospholipid; D000925:Anticoagulants; D017320:HIV Protease Inhibitors; D019469:Indinavir; D001241:Aspirin