Impact of short-term antiretroviral therapy (START) on some fibrinolytic markers in HIV-infected Nigerian adults: preliminary findings from the START study

Zaccheaus A Jeremiah1, Yetunde Obazee2, Godwin R Okogun3, Teddy C Adias4, Osaro Mgbere5,6, Ekere J Essien61Hematology and Blood Transfusion Science Unit, Department of Medical Laboratory Sciences, College of Health Sciences, Niger Delta University, Wilberforce Island, Bayelsa State, 2General Hospita...

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Autores principales:	Jeremiah ZA, Obazee Y, Okogun GR, Adias TC, Mgbere O, Essien EJ
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/d4ab3a6486184bd5bdc364044e510a6d
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spelling	oai:doaj.org-article:d4ab3a6486184bd5bdc364044e510a6d2021-12-02T05:00:48ZImpact of short-term antiretroviral therapy (START) on some fibrinolytic markers in HIV-infected Nigerian adults: preliminary findings from the START study1179-1373https://doaj.org/article/d4ab3a6486184bd5bdc364044e510a6d2012-07-01T00:00:00Zhttp://www.dovepress.com/impact-of-short-term-antiretroviral-therapy-start-on-some-fibrinolytic-a10347https://doaj.org/toc/1179-1373Zaccheaus A Jeremiah1, Yetunde Obazee2, Godwin R Okogun3, Teddy C Adias4, Osaro Mgbere5,6, Ekere J Essien61Hematology and Blood Transfusion Science Unit, Department of Medical Laboratory Sciences, College of Health Sciences, Niger Delta University, Wilberforce Island, Bayelsa State, 2General Hospital, Maitama District, Abuja, Federal Capital Territory, 3Department of Medical Laboratory Science, Ambrose Ali University, Ekpoma, Edo State, Nigeria; 4College of Health Technology, Bayelsa State, Nigeria; 5Houston Department of Health and Human Services, 6Institute of Community Health, University of Houston, Texas Medical Center, Houston, TX, USABackground: Derangement in fibrinolytic markers can result in thrombosis and cardiovascular problems. Antiretroviral therapy (ART) has been reported to affect the levels of these markers. It is unclear how long a patient can be exposed to ART before the effect of the drugs on the fibrinolytic markers becomes noticeable; this short-term antiretroviral therapy (START) study aimed to answer this question.Methods: Twenty human immunodeficiency virus (HIV)-positive subjects on ART and 20 controls (non-ART) were progressively monitored for three months. CD4 T-cell count was determined while D-dimer, t-PA, and PAI-1 parameters were determined.Results: CD4 T-cell count increased from 192 &micro;L/mL at baseline to 323 &micro;L/mL at month 3 among patients on ART. D-dimer concentrations decreased from 301.0 &micro;L/mL at baseline to 172.0 &micro;L/mL at month 2, then increased to 226.0 &micro;L/mL at the end of the third month. The median baseline concentration of PAI-1 at the beginning of therapy was 14.0 &micro;g/mL, which increased progressively to 18.2 &micro;g/mL at the end of the third month. The baseline concentration of t-PA at the beginning of therapy was 5.15 &micro;g/mL. This progressively declined to 1.10 &micro;g/mL at the end of the first month and reached 1.45 &micro;g/mL and 1.5 &micro;g/mL at the end of the second and third months, respectively. D-dimer was positively and significantly correlated with CD4 cell counts in both AIDs-associated retrovirus (ARV) and non-ARV patients (r = &ndash;0.304, P &lt; 0.01 vs r = &ndash;0.477, P &lt; 0.001). t-PA was negatively correlated with CD4 T-lymphocytes in those undergoing ART (r = &ndash;0.294, P &lt; 0.01).Conclusion: A progressive increase in PAI-1 and steady decline in t-PA concentrations within 3 months of commencement of ART could predispose patients to thrombotic disorders earlier than is expected. Pre-thrombotic assessment during therapy is therefore advocated.Keywords: fibrinolytic markers, D-dimer, t-PA, PAI-1, START studyJeremiah ZAObazee YOkogun GRAdias TCMgbere OEssien EJDove Medical PressarticleImmunologic diseases. AllergyRC581-607ENHIV/AIDS: Research and Palliative Care, Vol 2012, Iss default, Pp 87-94 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Immunologic diseases. Allergy RC581-607
spellingShingle	Immunologic diseases. Allergy RC581-607 Jeremiah ZA Obazee Y Okogun GR Adias TC Mgbere O Essien EJ Impact of short-term antiretroviral therapy (START) on some fibrinolytic markers in HIV-infected Nigerian adults: preliminary findings from the START study
description	Zaccheaus A Jeremiah1, Yetunde Obazee2, Godwin R Okogun3, Teddy C Adias4, Osaro Mgbere5,6, Ekere J Essien61Hematology and Blood Transfusion Science Unit, Department of Medical Laboratory Sciences, College of Health Sciences, Niger Delta University, Wilberforce Island, Bayelsa State, 2General Hospital, Maitama District, Abuja, Federal Capital Territory, 3Department of Medical Laboratory Science, Ambrose Ali University, Ekpoma, Edo State, Nigeria; 4College of Health Technology, Bayelsa State, Nigeria; 5Houston Department of Health and Human Services, 6Institute of Community Health, University of Houston, Texas Medical Center, Houston, TX, USABackground: Derangement in fibrinolytic markers can result in thrombosis and cardiovascular problems. Antiretroviral therapy (ART) has been reported to affect the levels of these markers. It is unclear how long a patient can be exposed to ART before the effect of the drugs on the fibrinolytic markers becomes noticeable; this short-term antiretroviral therapy (START) study aimed to answer this question.Methods: Twenty human immunodeficiency virus (HIV)-positive subjects on ART and 20 controls (non-ART) were progressively monitored for three months. CD4 T-cell count was determined while D-dimer, t-PA, and PAI-1 parameters were determined.Results: CD4 T-cell count increased from 192 &micro;L/mL at baseline to 323 &micro;L/mL at month 3 among patients on ART. D-dimer concentrations decreased from 301.0 &micro;L/mL at baseline to 172.0 &micro;L/mL at month 2, then increased to 226.0 &micro;L/mL at the end of the third month. The median baseline concentration of PAI-1 at the beginning of therapy was 14.0 &micro;g/mL, which increased progressively to 18.2 &micro;g/mL at the end of the third month. The baseline concentration of t-PA at the beginning of therapy was 5.15 &micro;g/mL. This progressively declined to 1.10 &micro;g/mL at the end of the first month and reached 1.45 &micro;g/mL and 1.5 &micro;g/mL at the end of the second and third months, respectively. D-dimer was positively and significantly correlated with CD4 cell counts in both AIDs-associated retrovirus (ARV) and non-ARV patients (r = &ndash;0.304, P &lt; 0.01 vs r = &ndash;0.477, P &lt; 0.001). t-PA was negatively correlated with CD4 T-lymphocytes in those undergoing ART (r = &ndash;0.294, P &lt; 0.01).Conclusion: A progressive increase in PAI-1 and steady decline in t-PA concentrations within 3 months of commencement of ART could predispose patients to thrombotic disorders earlier than is expected. Pre-thrombotic assessment during therapy is therefore advocated.Keywords: fibrinolytic markers, D-dimer, t-PA, PAI-1, START study
format	article
author	Jeremiah ZA Obazee Y Okogun GR Adias TC Mgbere O Essien EJ
author_facet	Jeremiah ZA Obazee Y Okogun GR Adias TC Mgbere O Essien EJ
author_sort	Jeremiah ZA
title	Impact of short-term antiretroviral therapy (START) on some fibrinolytic markers in HIV-infected Nigerian adults: preliminary findings from the START study
title_short	Impact of short-term antiretroviral therapy (START) on some fibrinolytic markers in HIV-infected Nigerian adults: preliminary findings from the START study
title_full	Impact of short-term antiretroviral therapy (START) on some fibrinolytic markers in HIV-infected Nigerian adults: preliminary findings from the START study
title_fullStr	Impact of short-term antiretroviral therapy (START) on some fibrinolytic markers in HIV-infected Nigerian adults: preliminary findings from the START study
title_full_unstemmed	Impact of short-term antiretroviral therapy (START) on some fibrinolytic markers in HIV-infected Nigerian adults: preliminary findings from the START study
title_sort	impact of short-term antiretroviral therapy (start) on some fibrinolytic markers in hiv-infected nigerian adults: preliminary findings from the start study
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/d4ab3a6486184bd5bdc364044e510a6d
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Impact of short-term antiretroviral therapy (START) on some fibrinolytic markers in HIV-infected Nigerian adults: preliminary findings from the START study

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