TY  - JOUR
A1  - Borges, Alvaro H.
A1  - O'Connor, Jemma L.
A1  - Phillips, Andrew N.
A1  - Baker, Jason V.
A1  - Vjecha, Michael J.
A1  - Losso, Marcelo H.
A1  - Klinker, Hartwig
A1  - Lopardo, Gustavo
A1  - Williams, Ian
A1  - Lundgren, Jens D.
T1  - Factors Associated with D-Dimer Levels in HIV-Infected Individuals
T2  - PLOS ONE
N2  - 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.
KW  - fibrin D-dimer
KW  - all-cause mortality
KW  - antiretroviral therapy
KW  - plasma D-dimer
KW  - elderly persons
KW  - coagulation
KW  - biomarkers
KW  - disease
KW  - interleukin-6
KW  - adults
Y1  - 2014
UR  - https://opus.bibliothek.uni-wuerzburg.de/frontdoor/index/index/docId/11709
UR  - https://nbn-resolving.org/urn:nbn:de:bvb:20-opus-117094
VL  - 9
IS  - 3
ER  -