Plasma levels of fibrinolytic and coagulation biomarkers in HIV-infected individuals on highly active antiretroviral therapy: A case-control study in a Northern Ghanaian population

Charles A Derigubah; Charles Nkansah; Kofi Mensah; Samuel K Appiah; Felix Osei-Boakye; Enoch Odame; Michael Owusu; Dorcas Serwaa; Maxwell A Hubert; Simon Bannison Bani; Eugene Kuugbee; Razak G Issahaku; Alexander Y Debrah; Otchere Addai-Mensah

doi:10.1002/hsr2.1436

Plasma levels of fibrinolytic and coagulation biomarkers in HIV-infected individuals on highly active antiretroviral therapy: A case-control study in a Northern Ghanaian population

Health Sci Rep. 2023 Jul 21;6(7):e1436. doi: 10.1002/hsr2.1436. eCollection 2023 Jul.

Authors

Charles A Derigubah^{1

2}, Charles Nkansah^{3

4}, Kofi Mensah^{3

4}, Samuel K Appiah^{3

4}, Felix Osei-Boakye⁵, Enoch Odame², Michael Owusu^{2

6}, Dorcas Serwaa⁷, Maxwell A Hubert⁸, Simon Bannison Bani⁹, Eugene Kuugbee¹⁰, Razak G Issahaku¹¹, Alexander Y Debrah², Otchere Addai-Mensah²

Affiliations

¹ Department of Medical Laboratory Technology School of Applied Science and Arts, Bolgatanga Technical University Bolgatanga Ghana.
² Department of Medical Diagnostics Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology Kumasi Ghana.
³ Department of Haematology School of Allied Health Sciences, University for Development Studies Tamale Ghana.
⁴ Department of Medical Laboratory Sciences Faculty of Health Science and Technology, Ebonyi State University Abakaliki Nigeria.
⁵ Department of Medical Laboratory Technology Faculty of Applied Science and Technology, Sunyani Technical University Sunyani Ghana.
⁶ Department of Molecular Biology Kumasi Centre for Collaborative Research (KCCR) Kumasi Ghana.
⁷ Department of Obstetrics and Gynaecology University of Melbourne Melbourne Australia.
⁸ Department of Medical Laboratory Science Koforidua Technical University Koforidua Ghana.
⁹ Department of Biomedical Laboratory Sciences School of Allied Health Sciences, University for Development Studies Tamale Ghana.
¹⁰ Department of Clinical Microbiology, School of Medicine and Health Sciences University for Development Studies Tamale Ghana.
¹¹ Department of Medical Laboratory Tamale Teaching Hospital Tamale Ghana.

Abstract

Background and aim: Impaired coagulation and fibrinolysis have been implicated in thromboembolism in human immunodeficiency virus (HIV)-infected individuals. This study evaluated the plasma levels of plasminogen activator inhibitor-1 (PAI-1) and coagulation biomarkers in HIV-infected individuals on highly active antiretroviral therapy (HAART).

Methods: This matched case-control study from March to December, 2020 comprised 76 participants: 38 HIV-positive individuals on HAART and 38 apparently healthy HIV-negative individuals as controls. Blood samples were collected for prothrombin time (PT), activated partial thromboplastin time (aPTT), D-dimers, PAI-1, and soluble fibrin monomer complex (SFMC) estimations. The data were analysed using SPSS version 22.0 and statistical significance was set at p < 0.05.

Results: Activated partial thromboplastin time was significantly lower in HIV seropositive individuals on HAART compared with HIV seronegative controls (25.90 s vs. 29.0 s, p = 0.030); however, PT, SFMC, D-dimers, and PAI-1 were significantly higher among the HIV-seropositive individuals compared with the controls: PT: (16.29 s ± 2.16 vs. 15.15 s ± 2.60, p = 0.010), SFMC: [8.53 ng/mL (8.03-9.12) vs. 7.84 ng/mL (7.32-8.58), p = 0.005]), D-Dimer: [463.37 ng/mL (402.70-526.33) vs. 421.11 ng/mL (341.11-462.52), p = 0.015], and PAI-1: [12.77 ng/mL (10.63-14.65) vs. 11.27 ng/mL (10.08-12.95), p = 0.039]. PAI-1 showed a moderate positive correlation with D-Dimer (r = 0.659, p < 0.001) and SFMC (r = 0.463, p = 0.003) among HIV-positive individuals on HAART. There was a strong positive correlation between the plasma PAI-1 concentration and the HIV viral load (r = 0.955, p < 0.001).

Conclusion: HIV-seropositive individuals on HAART have deranged coagulation and fibrinolytic markers. Higher HIV viral load correlates strongly with elevated plasma levels of PAI-1 antigens. Periodic assessment of markers of coagulation and fibrinolysis be included in the management of HIV/AIDS in Ghana.

Keywords: AIDS; D‐Dimers; HAART; HIV; PAI‐1.