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.show moreshow less

Download full text files

Export metadata

Additional Services

Share in Twitter Search Google Scholar Statistics
Metadaten
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
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):License LogoCC BY: Creative-Commons-Lizenz: Namensnennung