TITLE:
Down Regulated Protein C Plasma Levels in the Absence of Factor V Leiden Mutation in HIV Patients: An Observational Study in Maiduguri, North-Eastern Nigeria
AUTHORS:
Simon O. Obi, Ballah Akawu Denue, Ifeanyi Chukwu O. Martin, Marycelin M. Baba, Grace I. Amilo, Salihu Aliyu Kwayabura, Obi Ejeatulu
KEYWORDS:
HIV Infection, Protein C, Factor V Leiden Mutation
JOURNAL NAME:
World Journal of AIDS,
Vol.5 No.2,
May
28,
2015
ABSTRACT: Background: As life expectancy of
HIV-infected patients increases with use of highly active antiretroviral
therapy (HAART), protean haematologic manifestation including decreased activity
of natural anticoagulants such as protein C may occur in the absence of genetic
risk factors. Based on this preposition, we assessed the plasma level of
protein C, and prevalence of factor V Leiden mutation among HIV-infected
individuals. Our cohort consisted of 499 HIV-infected patients, of which 250
had AIDS, while 249 were either asymptomatic or had minor mucocutaneous
infection consistent with WHO clinical stages I and II without features of
AIDS. We also evaluated 251 healthy, HIV-negative subjects as controls. All
participants were tested for plasma protein C levels and factor V Leiden (FVL)
mutation (Arg 506 Gln) by automation and amplification created restriction
enzyme site (ACRES) polymerase chain reaction, respectively. The prevalence of
reduced protein C plasma levels among HIV positive patients was 20%; it was
more prevalent among those that had AIDS compared with those without features
of AIDS, but within WHO clinical stage I and II, (93.3% vs 6.7%) respectively.
None of the control patients had either reduced protein C nor FVL mutation. All
participants that demonstrated reduced protein C plasma levels demonstrated
normal FVL genotype (1691G/G). Conclusion: Decreased protein C plasma levels
can occur in HIV-infected patients in the absence of factor V Leiden mutation.
The risk increases with severity of the disease. Deranged protein C plasma
level increases the risk of hypercoagulable state in patients with advanced
HIV disease; it should be considered among the causes of thrombo embolism in
this group of patients.