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https://observatorio.fm.usp.br/handle/OPI/33347
Title: | Factors Associated with D-Dimer Levels in HIV-Infected Individuals |
Authors: | BORGES, Alvaro H.; O'CONNOR, Jemma L.; PHILLIPS, Andrew N.; BAKER, Jason V.; VJECHA, Michael J.; LOSSO, Marcelo H.; KLINKER, Hartwig; LOPARDO, Gustavo; WILLIAMS, Ian; LUNDGREN, Jens D. |
Citation: | PLOS ONE, v.9, n.3, article ID e90978, 11p, 2014 |
Abstract: | Background: Higher plasma D-dimer levels are strong predictors of mortality in HIV+ individuals. The factors associated with D-dimer levels during HIV infection, however, remain poorly understood. Methods: In this cross-sectional study, participants in three randomized controlled trials with measured D-dimer levels were included (N = 9,848). Factors associated with D-dimer were identified by linear regression. Covariates investigated were: age, gender, race, body mass index, nadir and baseline CD4(+) count, plasma HIV RNA levels, markers of inflammation (C-reactive protein [CRP], interleukin-6 [IL-6]), antiretroviral therapy (ART) use, ART regimens, co-morbidities (hepatitis B/C, diabetes mellitus, prior cardiovascular disease), smoking, renal function (estimated glomerular filtration rate [eGFR] and cystatin C) and cholesterol. Results: Women from all age groups had higher D-dimer levels than men, though a steeper increase of D-dimer with age occurred in men. Hepatitis B/C co-infection was the only co-morbidity associated with higher D-dimer levels. In this subgroup, the degree of hepatic fibrosis, as demonstrated by higher hyaluronic acid levels, but not viral load of hepatitis viruses, was positively correlated with D-dimer. Other factors independently associated with higher D-dimer levels were black race, higher plasma HIV RNA levels, being off ART at baseline, and increased levels of CRP, IL-6 and cystatin C. In contrast, higher baseline CD4+ counts and higher high-density lipoprotein cholesterol were negatively correlated with D-dimer levels. Conclusions: D-dimer levels increase with age in HIV+ men, but are already elevated in women at an early age due to reasons other than a higher burden of concomitant diseases. In hepatitis B/C co-infected individuals, hepatic fibrosis, but not hepatitis viral load, was associated with higher D-dimer levels. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - HC/ICHC Artigos e Materiais de Revistas Científicas - IMT Artigos e Materiais de Revistas Científicas - LIM/56 Artigos e Materiais de Revistas Científicas - ODS/03 |
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art_BORGES_Factors_Associated_with_DDimer_Levels_in_HIVInfected_Individuals_2014.PDF | publishedVersion (English) | 845.85 kB | Adobe PDF | View/Open |
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