HIV Infection Is a Risk Factor for Venous Thromboembolism

Abstract

The reported incidence of venous thromboembolism (VTE) in patients with human immunodeficiency virus (HIV) infection has ranged from 0.25 to 0.96% in clinical studies, but up to 17% at autopsy. A preliminary analysis at our hospital suggested that the frequency of VTE among HIV-positive individuals might be higher than previously reported. To further evaluate this issue, we performed a retrospective study of patients with a diagnosis of VTE and/or HIV infection discharged from our hospital between July 1, 1998 and June 30, 1999. A total of 13,496 patients were discharged during the year of the study. There were 244 patients with VTE and 362 who were HIV-positive. Ten of the 244 patients with VTE were HIV-positive (4.1%). The frequency of VTE among HIV-positive individuals was 10/362 (2.8%) compared to 234/13134 (1.8%) in the non-HIV-positive group, but the difference is not statistically significant. However, in patients under age 50, the frequencies were significantly different: 10/302 (3.31%) versus 35/6594 (0.53%), respectively (p < 0.0001). The frequency of VTE in HIV-positive patients less than 50 years old (3.31%) was greater than in HIV-positive patients over 50 years of age (0/60), but the difference did not reach statistical significance. In contrast, in the non-HIV-positive group, VTE was significantly more frequent in those 50 and older compared to younger patients (3.04% versus 0.53%, p = 0.0001). Statistical analysis indicated that the direction of association between age and diagnosis of VTE differed for HIV-positive patients versus non-HIV-positive patients. Our results suggest that HIV-positive patients under age 50 are at increased risk for VTE compared with non-HIV-positive individuals.

Risk factors and HIV infection among patients diagnosed with deep vein thrombosis at a regional/tertiary hospital in Kimberley, South Africa

“…The data also showed Previous studies have also shown the association between HIV and VTE (DVT). 4,16 The HIV infection being a prothrombotic condition, multiple factors have been described as of HIV-related venous thromboembolism aetiology. 4,12,20 It was recognised 20 years ago that HIV disease causes a prothrombotic condition but little evidence is known regarding the mechanism.…”

“…4,16 The HIV infection being a prothrombotic condition, multiple factors have been described as of HIV-related venous thromboembolism aetiology. 4,12,20 It was recognised 20 years ago that HIV disease causes a prothrombotic condition but little evidence is known regarding the mechanism. 21 A study by Jong et al showed that initiation of antiretroviral therapy improves the markers of endothelial cell activation, coagulation and natural anticoagulation in South African HIV-infected individuals.…”

“…3 Copur et al reported that the human immunodeficiency virus (HIV) also increases the risk of VTE. 4 In a retrospective review of patients with diagnosed DVT in an urban district in KwaZulu-Natal, South Africa, Awolesi et al reported that HIV (51.85%) and tuberculosis (TB) (35.80%) were prevalent risk factors. 5 Additional risk factors also reported in their study population were recent hospitalisation, smoking, previous DVT, and congestive heart failure.…”

“…12 Copur et al reported that HIVpositive patients under the age of 50 were at increased risk for VTE compared with HIV-negative patients in the same age range. 4 Studies have been done within the Southern Africa context to determine the association between HIV infection and DVT. 8,9,11,13 A retrospective review of patients with confirmed DVT at an urban Cape Town public hospital reported a clear association between HIV, TB and the development of DVT.…”

Mixed Arterial and Venous Thromboembolism in a Person with HIV Infection

“…The reported incidence of VTE in persons with HIV infection ranges from 0.25 to 3.31% per y in clinical studies, but up to 17% in post mortem studies (2). On the other hand, only a few cases of isolated arterial embolism have been reported in persons with HIV infection (3,4).…”