Factors Associated with D-Dimer Levels in HIV-Infected Individuals
Please always quote using this URN: urn:nbn:de:bvb:20-opus-117094
- 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 ofBackground: 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.…
Author: | Alvaro H. Borges, Jemma L. O'Connor, Andrew N. Phillips, Jason V. Baker, Michael J. Vjecha, Marcelo H. Losso, Hartwig Klinker, Gustavo Lopardo, Ian Williams, Jens D. Lundgren |
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URN: | urn:nbn:de:bvb:20-opus-117094 |
Document Type: | Journal article |
Faculties: | Medizinische Fakultät / Medizinische Klinik und Poliklinik II |
Language: | English |
Parent Title (English): | PLOS ONE |
Year of Completion: | 2014 |
Volume: | 9 |
Issue: | 3 |
Pagenumber: | e90978 |
Source: | PLoS ONE 9(3): e90978. doi:10.1371/journal.pone.0090978 |
DOI: | https://doi.org/10.1371/journal.pone.0090978 |
Pubmed Id: | https://pubmed.ncbi.nlm.nih.gov/24626096 |
Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Tag: | adults; all-cause mortality; antiretroviral therapy; biomarkers; coagulation; disease; elderly persons; fibrin D-dimer; interleukin-6; plasma D-dimer |
Release Date: | 2015/08/14 |
Contributing Corporation: | INSIGHT SMART and ESPRIT Study Groups ; SILCAAT Scientific Committee |
Licence (German): | CC BY: Creative-Commons-Lizenz: Namensnennung |