ACTIVATION OF COAGULATION AND FIBRINOLYSIS IN HIV-INFECTED PATIENTS

Various coagulation abnormalities were reported in HIV-infected patien ts, which were usually considered as risk factors for thrombosis in th e general population or in other disease states. This study was undert aken to determine whether HIV-infection was associated with an on-goin g pre/prothrombotic state, For that purpose, 70 consecutive HIV-infect ed out-patients were evaluated at distance of any acute episode, (55 m ales and 15 females with a mean age of 34 years,range: 19-69). 29 pati ents (41%) with a CD4+ lymphocytes count below 200 x 1O(6)/L were clas sified as having AIDS. The control group consisted of 33 age and sex-m atched healthy individuals, The plasma levels of sensitive markers of thrombin generation (prothrombin fragment 1 + 2 and thrombin-antithrom bin complex), plasmin generation (plasmin-plasmin inhibitor complex), and plasmin activity (fibrin degradation products) were measured using ELISAs. The plasma level of these markers were significantly higher i n HIV-injected patients than in healthy HIV-negative controls, Moreove r, the plasma levels of these markers were found to be highly signific antly correlated (p < 0.001) in the patients group, suggesting an incr eased activation of both coagulation and fibrinolysis. However, despit e trends toward increasing levels with decreasing CD4+ lymphocyte coun t, the plasma levels of these markers were not significantly different in AIDS and in non AIDS patients (classified upon the CD4+ lymphocyte s count below and above 200 x 10(6)/L), These results suggest that HIV -infection is associated with an activation of both the coagulation an d fibrinolytic systems, which could lead to a prothrombotic state in s ome of the patients.