Abstract
The number of people infected with human immunodeficiency virus (HIV) is rapidly increasing
and the majority of those infected are living in sub-Saharan Africa. Some hallmarks
of HIV are inflammation and upregulation of inflammatory markers. A pathological coagulation
system may accompany these inflammatory changes and potentially result in venous thromboembolism
such as a deep vein thrombosis (DVT). In this review, the authors describe the inflammatory
profile in HIV, the treatment regimens currently in place in South Africa, and in
particular how HIV affects the hematological system, with specific focus on platelets,
red blood cells (RBCs; erythrocytes), and fibrin(ogen). They also discuss the presence
of DVT in HIV, focus on screening tests, and suggest a more proactive approach to
track the inflammatory profile of HIV patients, by specifically using parameters that
might point to pathological coagulation; these should involve platelet, RBC, and fibrin(ogen)
analysis. They conclude by suggesting that including coagulation function tests to
study the effect of treatment interventions would improve outcomes in these individuals,
as it could help in the diagnosis of thromboembolic disease. Furthermore, this approach
could streamline treatment strategies due to improved monitoring. A better understanding
of hypercoagulability of HIV-infected patients is therefore urgently needed. In conclusion,
the authors suggest a panel of pathology tests that should be considered as standard
procedures when HIV is present.
Keywords
human immunodeficiency virus - deep vein thrombosis - antiretroviral medication -
inflammation - coagulation
