Differential Plasma Levels of D dimer and P Selectin and Their Correlation with CD4+ Cell Counts in Pretreatment HIV positive Patients

Abstract

Background: Untreated HIV infection is associated with an increased risk of venous thromboembolism (VTE) with attendant high morbidity and mortality. Plasma levels of D-dimer and P-selectin are known markers of coagulation and platelet activation, respectively, and are potentially useful in VTE screening. The aim of this study was to assay D-dimer and P-selectin levels in pretreatment HIV-positive patients and to assess their correlation with the immune status of the patients based on CD4+ counts. Materials and Methods: This was a comparative cross-sectional study of 90 pretreatment HIV-positive patients and HIV-negative normal blood donors selected as a comparison group (total n = 180). The study was carried out at Aminu Kano Teaching Hospital, Kano, Nigeria. Plasma D-dimer and P-selectin levels were assayed using standard enzyme‐linked immunosorbent assay protocols, whereas CD4⁺ counts were measured using a standard flow cytometry technique. Results: The mean plasma D-dimer level in the study group (320.3 ± 148.9 ng/ml) was higher than that of the comparison group (299 ± 175.2 ng/ml), but the difference was not statistically significant (p = 0.390). Similarly, the plasma P-selectin level in the study group was higher than that of the comparison group and the difference was statistically significant (p < 0.001). Both plasma D-dimer and P-selectin levels negatively correlated with CD4⁺ counts, but only P‐selectin levels were statistically significant. Conclusion: Plasma P‐selectin level is significantly high in pretreatment HIV patients, negatively correlated with CD4⁺ counts, and maybe a useful marker for immunological failure and assessment of the risk of VTE in HIV-infected patients.