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dc.contributor.author | Borges, Álvaro H. |
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dc.contributor.author | O'Connor, Jemma L. |
dc.contributor.author | Phillips, Andrew N. |
dc.contributor.author | Baker, Jason V. |
dc.contributor.author | Vjecha, Michael J. |
dc.contributor.author | Losso, Marcelo H. |
dc.contributor.author | Klinker, Hartwig |
dc.contributor.author | Lopardo, Gustavo |
dc.contributor.author | Williams, Ian |
dc.contributor.author | Lundgren, Jens D. |
dc.contributor.author | Gatell, José M. |
dc.contributor.author | INSIGHT SMART Study Group |
dc.contributor.author | ESPRIT Study Group |
dc.contributor.author | SILCAAT Scientific Committee |
dc.date | 2018-03-16T15:31:00Z |
dc.date | 2018-03-16T15:31:00Z |
dc.date | 2014-03-13 |
dc.date | 2018-03-16T15:31:00Z |
dc.identifier | 1932-6203 |
dc.identifier | 649153 |
dc.identifier | 24626096 |
dc.identifier.uri | http://hdl.handle.net/2445/120845 |
dc.description | 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. |
dc.format | 11 p. |
dc.format | application/pdf |
dc.language | eng |
dc.publisher | Public Library of Science (PLoS) |
dc.relation | Reproducció del document publicat a: https://doi.org/10.1371/journal.pone.0090978 |
dc.relation | PLoS One, 2014, vol. 9, num. 3, p. e90978 |
dc.relation | https://doi.org/10.1371/journal.pone.0090978 |
dc.rights | cc-by (c) Borges, Álvaro H. et al., 2014 |
dc.rights | http://creativecommons.org/licenses/by/3.0/es |
dc.rights | info:eu-repo/semantics/openAccess |
dc.subject | Infeccions per VIH |
dc.subject | Persones seropositives |
dc.subject | Plasma sanguini |
dc.subject | Fibrinòlisi |
dc.subject | Hepatitis |
dc.subject | HIV infections |
dc.subject | HIV-positive persons |
dc.subject | Blood plasma |
dc.subject | Fibrinolysis |
dc.subject | Hepatitis |
dc.title | Factors associated with D-dimer levels in HIV-infected individuals. |
dc.type | info:eu-repo/semantics/article |
dc.type | info:eu-repo/semantics/publishedVersion |