Hemostatic Profile and Associated Factors of Hemostatic Abnormality in Human Immunodeficiency Virus Infected Adults Attending Jimma University Specialized Hospital, Southwest Ethiopia: A Case-Control Study

Girum Tesfaye, T. Yemane, Lealem Gedefaw
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引用次数: 4

Abstract

Background: Human immunodeficiency virus infection has been proposed to inflict an insult on hemostatic system which involves endothelium, platelet and coagulation proteins. Information regarding hemostatic profile in human immunodeficiency virus infected patients is limited and contradicting too. Method: A case control study was conducted from April to May 2014 in Jimma University specialized hospital, involving 96 HIV infected patients and 96 healthy controls that came consecutively to comprehensive chronic care center and voluntary counseling and testing (VCT) center respectively. Socio demographic and clinical data were obtained using structured questionnaire. For the purpose of hemostasis tests, 2.7ml of venous blood sample was collected in a 3ml citrated (3.2%) vacuum tube. Platelet count and CD4 count was determined from a 3ml EDTA sample. Mixing study was undertaken for prolonged coagulation tests. Data were analyzed using SPSS, version 20. Result: The mean value of prothrombin time (PT), international normalized ratio(INR), activated partial thromboplastin time(APTT) and fibrinogen level was significantly higher in case group than control (p< 0.001, 0.01, <0.001 and <0.001) while mean platelet count was significantly lower in case group (p<0.0001). Mixing study showed correction of 35(87.5%) of 40 prolonged PT both in immediate and delayed test while 58(95.1%) of 60 prolonged activated APTT fail to correct in both situations. A CD4 count of less than 200cells/mm 3(AOR=8.8, 95% CI (1.8-42.4)) and HAART (AOR=3.4, 95%CI (1.2-10.1)) use were significantly associated with prolonged PT while a CD4 count of less than 200cells/mm3 (AOR=11.55, 95% CI (1.25-106)) was significantly associated with prolonged APTT. Conclusion: There was a significant mean difference between case and control groups with respect to PT, APTT, platelet count and fibrinogen level. Direction of the finding points towards presence of inhibitors and factor deficiency which demands in depth investigation and corresponding intervention.
在埃塞俄比亚西南部吉马大学专科医院接受人类免疫缺陷病毒感染的成年人的止血特征和相关因素:一项病例对照研究
背景:人类免疫缺陷病毒感染已被提出对包括内皮细胞、血小板和凝血蛋白在内的止血系统造成损害。关于人类免疫缺陷病毒感染患者止血概况的信息有限,也相互矛盾。方法:于2014年4 - 5月在吉马岛大学专科医院进行病例对照研究,分别纳入96例HIV感染者和96例健康对照者,分别于慢性综合护理中心和自愿咨询检测中心连续就诊。采用结构化问卷法获取社会人口学及临床资料。止血试验取静脉血2.7ml,置于3ml柠檬酸盐(3.2%)真空管中。从3ml EDTA样本中测定血小板计数和CD4计数。混合研究进行了长时间的凝血试验。数据分析使用SPSS,版本20。结果:病例组凝血酶原时间(PT)、国际标准化比值(INR)、活化部分凝血活素时间(APTT)、纤维蛋白原水平平均值均显著高于对照组(p< 0.001、0.01、<0.001、<0.001),血小板计数平均值显著低于对照组(p<0.0001)。混合研究显示,40例延长激活APTT在即时和延迟测试中均有35例(87.5%)纠正,而60例延长激活APTT在两种情况下均未能纠正58例(95.1%)。CD4计数小于200cells/mm3 (AOR=8.8, 95%CI(1.8-42.4))和HAART (AOR=3.4, 95%CI(1.2-10.1))使用与PT延长显著相关,而CD4计数小于200cells/mm3 (AOR=11.55, 95%CI(1.25-106))与APTT延长显著相关。结论:患者PT、APTT、血小板计数、纤维蛋白原水平与对照组比较差异有统计学意义。发现的方向指向抑制剂和因子缺乏的存在,需要深入调查和相应的干预。
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