Derangement of protein S and C4b-binding protein levels as acquired thrombophilia in HIV-infected adult Nigerians

• Published in: Southern African journal of HIV medicine 2021, Vol.22 (1), p.1253-1253
• Main Authors: Bello, Fatai O, Akanmu, Alani S, Adeyemo, Titilope A, Idowu, Bukunmi M, Okonkwo, Prosper, Kanki, Phyllis J
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adults; AIDS; Anticoagulants; Antiretroviral agents; Antiretroviral therapy; Antiviral agents; Blood clots; C4b-binding protein; clot lysis; euglobulin clot lysis time; fibrinolysis; Hematology; HIV; HIV (Viruses); HIV patients; Human immunodeficiency virus; Infections; Inflammation; Laboratories; Lysis; Original Research; Patients; Plasma; Polyethylene glycol; Population studies; Protein binding; protein c deficiency; Protein deficiency; Protein S; protein s deficiency; Proteins; Serum levels; Standard deviation; Statistical analysis; Teaching hospitals; Thrombophilia; Thrombosis; tissue plasminogen activator; Variance analysis
• ISSN: 1608-9693; 2078-6751
• DOI: 10.4102/sajhivmed.v22i1.1253

HIV is a chronic inflammatory state with the production of many acute-phase-reactant proteins. Some of these proteins have procoagulant activities that predispose HIV-infected patients to thrombosis. The aim of the study was to evaluate the effects of HIV infection on the serum levels of C4b-binding protein (C4BP) and protein S as markers of predisposition to thrombosis in HIV-infected adults. The study population comprised of 61 HIV-infected adults on antiretroviral treatment (ART) who had achieved virological suppression, 58 HIV-infected adults not yet on ART and 59 HIV-negative healthy controls. The serum levels of free protein S, C4BP and the euglobulin clot lysis time (ECLT) were determined. The mean plasma-free protein S level of HIV-infected patients on ART (86.9% ± 25.8%) was significantly higher than that of treatment-naïve HIV-infected patients (75.7% ± 27.3%) ( = 0.005). Conversely, there was no statistically significant difference between the protein S levels of the HIV-infected subjects on ART (86.9% ± 25.8%) and those of the controls (94.9% ± 7.9%) ( = 0.119). The mean C4BP was significantly higher in the treatment-naïve HIV-infected subjects (36.7 ± 1.7 ng/dL) than that in those on ART (30.7 ± 2.6 ng/dL) and that in the controls (22.4 ± 2.4 ng/dL) ( < 0.0001). Protein S deficiency was more prevalent among the subjects with elevated C4BP ( = 0.023). The mean ECLT was significantly more prolonged in the treatment-naïve HIV-infected subjects (241.9 ± 34.7 s) than controls (189.5 ± 40.7 s) (p