Thromboses among HIV-Infected Patients during the HAART Era
Abstract
Venous thrombotic events (VTEs) may occur at higher rates among patients with HIV; some studies suggest that highly active antiretroviral therapy (HAART) may increase the risk for these potentially life-threatening events. We performed a retrospective study among patients with HIV to evaluate the incidence and risk factors for VTEs during the HAART era. A literature review was performed examining VTEs in the pre- and post-HAART eras. Seventeen (3.7%) of 465 patients with HIV experienced a VTE. The overall incidence rate of deep VTEs among HIV-positive persons was 377 cases per 100,000 person–years, a fourfold higher rate compared to age-matched males in the general population. The median age at VTE was 36 years (range, 27–68). Patients with a thrombosis compared to those without had significantly lower current CD4 (153 versus 520 cells/mm3, p < 0.001) and nadir (76 versus 276 cells/mm3, p < 0.001) CD4 counts, higher viral loads (3.6 versus 1.7 log10 copies per milliliter, p = 0.003), and more likely to have a diagnosis of AIDS (76% versus 32%, p < 0.001); there were no differences in demographics, hyperlipidemia, current use of HAART, the duration of HAART or protease inhibitor (PI) exposure. A review of the literature noted 129 VTE cases; mean age was 40 years, mean CD4 count was 181 cells/mm3, the majority of patients were not receiving HAART, and the most common risk factor was an ongoing infection. Thrombotic events are occurring among patients with HIV despite their…
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