ANTITHROMBIN AND HOMOCYSTEINE AS MARKERS FOR HYPERCOAGULABILITY IN PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS AND ACQUIRED IMMUNODEFICIENCY SYNDROME IN IBADAN

Abstract

Background: Human Immunodeficiency Virus (HIV) infection and the Acquired
Immunodeficiency Syndrome (AIDS) are both recognised as pro-thrombotic states.
Antithrombin is the most important naturally occurring anticoagulant while homocysteine, a
metabolic intermediate in the metabolism of methionine, is a common cause of
hypercoagulability. There is a relative paucity of studies on these key molecules involved in
coagulation in patients with HIV/AIDS in sub Saharan Africa.
Objectives: To determine the plasma levels of antithrombin and homocysteine in the HIV
(study) population and control population. To determine sociodemographic variables that
affect levels of both antithrombin and homocysteine and to investigate possible relationships
between the Cluster of Differentiation 4(CD 4) lymphocyte cell count, platelet counts and the
levels of both antithrombin and homocysteine.
Method: This cross-sectional study was carried out on 120 patients with HIV/AIDS who
attend the AIDS Prevention Initiative Nigeria (APIN) Clinic at the University College
Hospital, Ibadan and the St Mary’s Catholic Hospital Eleta, Ibadan within a three month
period. The controls numbered 126 seronegative blood donors from the University College
Hospital, Ibadan blood bank.
The plasma levels of homocysteine and antithrombin were estimated using enzyme linked
immunosorbent and colorimetric methods respectively and were compared with those of a
seronegative population. The CD4+ T cell count and the full blood count parameters were also
estimated using flow cytometry and standard automated methods respectively.
An independent sample t test was performed on the antithrombin and homocysteine. Chi
square was used to analyze nominal variables. Univariate analysis was carried out on
antithrombin, homocysteine and relevant sociodemographic factors. Measures of central
tendency and scatter were performed on all the parameters.
Results: The mean plasma values of antithrombin was 72.5% activity in the HIV positive
population as compared with 93.0% activity in the control group while the mean
homocysteine level was 24.4µmol/L in the HIV positive population as compared with
19.5µmol/L in the control group. Besides antithrombin, homocysteine, mean corpuscular
volume, haematocrit, haemoglobin concentration, platelet count as well as CD 4+ T cell
counts, there were no significant differences between seropositive and seronegative
individuals in the study.
Conclusion: The plasma antithrombin level appears to be significantly lower in the HIV
seropositive group compared with controls.Plasma homocysteine level appears to be
significantly higher in the HIV seropositive group compared with controls

ANTITHROMBIN AND HOMOCYSTEINE AS MARKERS FOR HYPERCOAGULABILITY IN PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS AND ACQUIRED IMMUNODEFICIENCY SYNDROME IN IBADAN