HAEMOSTATIC PARAMETERS AMONG HAART NAÏVE HIV/AIDS PATIENTS IN UNIVERSITY OF ILORIN TEACHING HOSPITAL, ILORIN

Abstract

Introduction: Infection with human immunodeficiency virus (HIV) is a progressive condition
which may cause endothelial dysfunction and liver damage leading to coagulopathy. With advent
of highly active antiretroviral therapy (HAART), life expectancy has prolonged in HIV positive
patients but several acquired immunodeficiency syndrome (AIDS)-related conditions such as
coagulopathies are responsible for associated morbidity and mortality.
Objectives: This study determined the haemostatic parameters among HAART naïve HIV/AIDS
patients namely prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin
time (TT), fibrinogen level and platelet count and compared it with HIV negative controls. The
relationship between CD4 count and these parameters was also determined.
Methodology: This was a case control study carried out at the University of Ilorin Teaching
Hospital. Blood samples were collected for determining the above haemostatic parameters. PT,
aPTT and TT were done manually, platelet count was analyzed by the SYSMEX KX 21
automated cell counter and serum fibrinogen was analyzed using the Centrionic GmbH
fibrinogen kit. Data generated was analyzed using the SPSS software version (2011) and the level
of significance was put at p-value <0.05.
Results: A total of 110 HAART naïve HIV/AIDS patients and 110 HIV negative controls were
studied. Fifty three (48.2%) were males and 57 (51.8%) were females with a male to female ratio
of 1.9:1.0. The mean age of the subjects was 38.69 + 10.87 years.
The mean values for PT and aPTT were significantly higher in the subjects than the controls (p <
0.001). The mean values of TT and platelet count were significantly lower in subjects than in
controls (p < 0.012 and 0.029). The median (interquartile range) values of fibrinogen among
subjects was 241.8mg/l (86.8) which was significantly higher than corresponding values in
controls of 227.9mg/l (95.8). ( p < 0.001)
The odds of having abnormal haemostatic parameter as regards PT and fibrinogen in subjects as
compared to controls is higher in subjects with odd’s ratio 4.853(95% CI 2.378- 9.902 , p-value
0.001) and odd’s ratio 2.742(95% CI 1.410 – 5.330 , p- value 0.009) respectively.
Over half of the subjects (51.8%) presented with a CD4 count below 200cells/µl. the odds of
having an abnormal PT was found to be 1.155 higher in those with CD4 count < 200cells/µl
(OR= 1.155, 95%CI= 1.006 – 1.327, p = 0.04) and 1.198 higher to have an abnormal TT(OR=
1.198, 95%CI=1.014 – 1.416, p = 0.03).

In conclusion, HAART naïve HIV/AIDS patients have a wide range of haemostatic
abnormalities. Therefore clinicians must be aware of the increased risk of these abnormalities in
other to avoid potential life threatening complications like pulmonary embolism and
haemorrhage.
It is recommended that the measurement of these haemostatic parameters be carried out in HIV
patients to have a baseline value before commencement of therapy and before going for any
invasive procedures or major surgeries.

HAEMOSTATIC PARAMETERS AMONG HAART NAÏVE HIV/AIDS PATIENTS IN UNIVERSITY OF ILORIN TEACHING HOSPITAL, ILORIN