       Document 0155
 DOCN  M9620155
 TI    Thrombotic tendencies and correlation with clinical status in patients
       infected with HIV.
 DT    9602
 AU    Feffer SE; Fox RL; Orsen MM; Harjai KJ; Glatt AE; Department of
       Medicine, Nassau County Medical Center, East; Meadow, NY 11554, USA.
 SO    South Med J. 1995 Nov;88(11):1126-30. Unique Identifier : AIDSLINE
       MED/96049159
 AB    Previous publications have described thrombotic events with unclear
       causes in individuals infected with the human immunodeficiency virus
       (HIV). We stratified the cases of 52 individuals infected with HIV by
       degree of immunosuppression and the presence of complicating illnesses.
       Plasma from these individuals was screened for abnormalities that might
       predispose to thromboses. We found statistically significant differences
       between patients with CD4 counts < 200/mm3 and those whose CD4 counts
       were > 400/mm3 in the following: d-dimers, functional protein C,
       antigenic protein C, total protein S antigen, free protein S antigen,
       C4b-binding protein (C4b-BP), and von Willebrand antigen (vWD). Free
       protein S correlated inversely with C4b-BP; vWD directly with total
       protein S; and protein C inversely with d-dimers. D-dimers were
       significantly elevated only in immunosuppressed patients with
       complicating neoplastic/inflammatory disease. We propose that low-grade
       disseminated intravascular coagulopathy in severely immunosuppressed
       individuals with HIV and infectious, inflammatory, or neoplastic
       complications is responsible for depressed protein C, which, together
       with elevations in total protein S and vWD (markers of endothelial
       injury), indicates a thrombotic predisposition.
 DE    von Willebrand Factor/ANALYSIS  Adult  Antifibrinolytic Agents/BLOOD
       AIDS-Related Opportunistic Infections/BLOOD/COMPLICATIONS  CD4
       Lymphocyte Count  Disseminated Intravascular
       Coagulation/BLOOD/COMPLICATIONS  Female  Fibrin Fibrinogen Degradation
       Products/ANALYSIS  Human  HIV Infections/BLOOD/*COMPLICATIONS/IMMUNOLOGY
       Immunocompromised Host  Inflammation  Male
       Neoplasms/BLOOD/COMPLICATIONS  Protein C/ANALYSIS  Protein S/ANALYSIS
       Risk Factors  Thrombosis/BLOOD/*COMPLICATIONS  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

