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Title: | Factors associated with D-dimer levels in HIV-infected individuals. |
Author: | Borges, Álvaro H. O'Connor, Jemma L. Phillips, Andrew N. Baker, Jason V. Vjecha, Michael J. Losso, Marcelo H. Klinker, Hartwig Lopardo, Gustavo Williams, Ian Lundgren, Jens D. Gatell, José M. INSIGHT SMART Study Group ESPRIT Study Group SILCAAT Scientific Committee |
Keywords: | Infeccions per VIH Persones seropositives Plasma sanguini Fibrinòlisi Hepatitis HIV infections HIV-positive persons Blood plasma Fibrinolysis Hepatitis |
Issue Date: | 13-Mar-2014 |
Publisher: | Public Library of Science (PLoS) |
Abstract: | BACKGROUND: Higher plasma D-dimer levels are strong predictors of mortality in HIV+ individuals. The factors associated with D-dimer levels during HIV infection, however, remain poorly understood. METHODS: In this cross-sectional study, participants in three randomized controlled trials with measured D-dimer levels were included (N = 9,848). Factors associated with D-dimer were identified by linear regression. Covariates investigated were: age, gender, race, body mass index, nadir and baseline CD4+ count, plasma HIV RNA levels, markers of inflammation (C-reactive protein [CRP], interleukin-6 [IL-6]), antiretroviral therapy (ART) use, ART regimens, co-morbidities (hepatitis B/C, diabetes mellitus, prior cardiovascular disease), smoking, renal function (estimated glomerular filtration rate [eGFR] and cystatin C) and cholesterol. RESULTS: Women from all age groups had higher D-dimer levels than men, though a steeper increase of D-dimer with age occurred in men. Hepatitis B/C co-infection was the only co-morbidity associated with higher D-dimer levels. In this subgroup, the degree of hepatic fibrosis, as demonstrated by higher hyaluronic acid levels, but not viral load of hepatitis viruses, was positively correlated with D-dimer. Other factors independently associated with higher D-dimer levels were black race, higher plasma HIV RNA levels, being off ART at baseline, and increased levels of CRP, IL-6 and cystatin C. In contrast, higher baseline CD4+ counts and higher high-density lipoprotein cholesterol were negatively correlated with D-dimer levels. CONCLUSIONS: D-dimer levels increase with age in HIV+ men, but are already elevated in women at an early age due to reasons other than a higher burden of concomitant diseases. In hepatitis B/C co-infected individuals, hepatic fibrosis, but not hepatitis viral load, was associated with higher D-dimer levels. |
Note: | Reproducció del document publicat a: https://doi.org/10.1371/journal.pone.0090978 |
It is part of: | PLoS One, 2014, vol. 9, num. 3, p. e90978 |
URI: | http://hdl.handle.net/2445/120845 |
Related resource: | https://doi.org/10.1371/journal.pone.0090978 |
ISSN: | 1932-6203 |
Appears in Collections: | Articles publicats en revistes (Medicina) Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) |
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