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Published version

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2014-03-13

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cc-by (c) Borges, Álvaro H. et al., 2014
Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/120845

Factors associated with D-dimer levels in HIV-infected individuals.

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https://doi.org/10.1371/journal.pone.0090978

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.

Subject

Infeccions per VIH, Persones seropositives, Plasma sanguini, Fibrinòlisi, Hepatitis

Subject (English)

HIV infections, HIV-positive persons, Blood plasma, Fibrinolysis, Hepatitis

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Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citation

BORGES, Álvaro H., et al. Factors associated with D-dimer levels in HIV-infected individuals. PLoS One. 2014. Vol. 9, num. 3, pags. e90978. ISSN 1932-6203. [consulted: 14 of August of 2026]. Available at: https://hdl.handle.net/2445/120845

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