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

Simon O. Obi¹, Ballah Akawu Denue^2*, Ifeanyi Chukwu O. Martin³, Marycelin M. Baba¹, Grace I. Amilo⁴, Salihu Aliyu Kwayabura⁵, Obi Ejeatulu⁶

¹Department of Medical Lab, Science College of Medicine, University of Maiduguri, Maiduguri, Nigeria.
²Department of Medicine, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria.
³Department of Immunology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria.
⁴Department of Haematology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria.
⁵Department of Obstetrics and Gynaecology, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria.
⁶Department of Pharmacology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria.

DOI: 10.4236/wja.2015.52009                

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.

Keywords

HIV Infection, Protein C, Factor V Leiden Mutation

Conflicts of Interest

The authors declare no conflicts of interest.

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