Contributions
Abstract: PB2052
Type: Publication Only
Background
Human Immunodeficiency Viral (HIV) infection is a chronic systemic inflammatory and thrombogenic condition. Protein C has well defined anticoagulant functions, however, its anti-inflammatory functions which act distinctively from the ‘anticoagulants’, with regards to structure, receptor, signaling pathway and effect, is an exploit of current active research. Understanding the dynamics of this protein in a condition like HIV infection may give some insight to the functionality of this unique molecule particularly in the Nigerian setting.
Aims
To determine the levels of protein C, some inflammatory markers; Erythrocyte Sedimentation Rate (ESR) and C-reactive Protein (CRP) and d-dimer (a marker of ongoing coagulation) in HIV infected patients and evaluate the relationship between protein C and these parameters.
Methods
This is a cross-sectional study that assessed the activity of Protein C using chromogenic methods (Technochrom), ESR using Westergreen method, CRP and D-dimer using ELISA test kits (Agappe and Immunoclon respectively) in a total of 210 participants comprising of three groups; HIV seronegative participants (n=70), HIV seropositive therapy naive participants (n=70) and HIV seropositive participants on HAART (n=70). Informed consent from each participant and an approval from the medical ethical committee of the institution where study was conducted were obtained.
Results
The mean protein C level in the seronegative, HAART naïve and HAART experienced participants were 0.618 ± 0.446 IU/ml, 0.548 ± 0.473 IU/ml and 0.340 ± 0.226 IU/ml respectively. There was a significant difference between the mean of the HAART naïve and HAART experienced participants (p< 0.001). The mean ESR and CRP in the seronegative, HAART naïve and HAART experienced participants were 21.1 ± 14.3 mm/hr and 18.77 ± 17.51 mg/dl; 71.2 ± 41.1 mm/hr and 39.92 ± 27.28 mg/dl; and 40.8 ± 35.3 mm/hr and 27.99 ± 21.54 mg/dl respectively. There was a significant difference across the three groups of participants (p< 0.001). The mean d-dimer levels for therapy naïve was 168.0 ± 41.0 mg/L and 168.0 ± 17.0 mg/L for the HAART experienced, the mean difference was statistically significant when compared with the seronegative participants (92.0±11.0 mg/L) p< 0.001. The correlation between protein C and other parameters assessed only showed a significant correlation with ESR (r= 0.36, p< 0.001).
Conclusion
ESR and CRP levels were significantly higher in HIV infected participants, though participant on HAART were associated with a much lower level of inflammatory markers. D-dimer levels were significantly higher with HIV infection and the elevations persisted despite HAART. Protein C levels were significantly lower with HAART when compared with the other groups of participants. Hemostasis is grossly altered in HIV infection despite an associated reduced inflammatory state with HAART.
Session topic: 31. Infectious diseases, supportive care
Keyword(s): Coagulation, HIV, inflammation, Protein C
Abstract: PB2052
Type: Publication Only
Background
Human Immunodeficiency Viral (HIV) infection is a chronic systemic inflammatory and thrombogenic condition. Protein C has well defined anticoagulant functions, however, its anti-inflammatory functions which act distinctively from the ‘anticoagulants’, with regards to structure, receptor, signaling pathway and effect, is an exploit of current active research. Understanding the dynamics of this protein in a condition like HIV infection may give some insight to the functionality of this unique molecule particularly in the Nigerian setting.
Aims
To determine the levels of protein C, some inflammatory markers; Erythrocyte Sedimentation Rate (ESR) and C-reactive Protein (CRP) and d-dimer (a marker of ongoing coagulation) in HIV infected patients and evaluate the relationship between protein C and these parameters.
Methods
This is a cross-sectional study that assessed the activity of Protein C using chromogenic methods (Technochrom), ESR using Westergreen method, CRP and D-dimer using ELISA test kits (Agappe and Immunoclon respectively) in a total of 210 participants comprising of three groups; HIV seronegative participants (n=70), HIV seropositive therapy naive participants (n=70) and HIV seropositive participants on HAART (n=70). Informed consent from each participant and an approval from the medical ethical committee of the institution where study was conducted were obtained.
Results
The mean protein C level in the seronegative, HAART naïve and HAART experienced participants were 0.618 ± 0.446 IU/ml, 0.548 ± 0.473 IU/ml and 0.340 ± 0.226 IU/ml respectively. There was a significant difference between the mean of the HAART naïve and HAART experienced participants (p< 0.001). The mean ESR and CRP in the seronegative, HAART naïve and HAART experienced participants were 21.1 ± 14.3 mm/hr and 18.77 ± 17.51 mg/dl; 71.2 ± 41.1 mm/hr and 39.92 ± 27.28 mg/dl; and 40.8 ± 35.3 mm/hr and 27.99 ± 21.54 mg/dl respectively. There was a significant difference across the three groups of participants (p< 0.001). The mean d-dimer levels for therapy naïve was 168.0 ± 41.0 mg/L and 168.0 ± 17.0 mg/L for the HAART experienced, the mean difference was statistically significant when compared with the seronegative participants (92.0±11.0 mg/L) p< 0.001. The correlation between protein C and other parameters assessed only showed a significant correlation with ESR (r= 0.36, p< 0.001).
Conclusion
ESR and CRP levels were significantly higher in HIV infected participants, though participant on HAART were associated with a much lower level of inflammatory markers. D-dimer levels were significantly higher with HIV infection and the elevations persisted despite HAART. Protein C levels were significantly lower with HAART when compared with the other groups of participants. Hemostasis is grossly altered in HIV infection despite an associated reduced inflammatory state with HAART.
Session topic: 31. Infectious diseases, supportive care
Keyword(s): Coagulation, HIV, inflammation, Protein C