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ISSN 0185-6014 (Print)
Órgano oficial de difusión de la Federación Mexicana de Patología Clínica, AC y de la Asociación Latinoamericana de Patología Clínica/Medicina de Laboratorio

2000, Number 2

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Rev Mex Patol Clin Med Lab 2000; 47 (2)

Protease inhibitors as inductors of secondary thrombophilia in AIDS patients

Sánchez-Barboza R, Majluf-Cruz A, García-Escamilla RM

Language: Spanish
References: 18
Page: 94-99
PDF size: 145.47 Kb.


ABSTRACT

Thrombosis is an uncommon complication of AIDS. In our hands, after almost 2000 attended patients, only two venous thrombotic episodes were found in an 8 - year period. However, an increase in these complications was observed in the last eight months. We report the results of the screening of 18 male patients with AIDS and venous thrombosis with an average age of 40 years old (range 29 to 51). Deep vein thrombosis was diagnosed in all patients. Two patients also had pulmonary thromboembolism and one more unilateral renal vein thrombosis. Confirmation of venous thrombosis was always confirmed. Since we had no clue about the possible etiology of these complications, we performed the screening of natural anticoagulants (functional levels of protein C, protein S and antithrombin III), Activated protein C resistance (FV Leiden if necessary), lupus anticoagulant and anticardiolipin antibodies. Hemostatic screening was performed 3 weeks after the thrombotic episode at least while the patient received low molecular weight heparin. Plasma samples for antithrombin-III screening were obtained after oral anticoagulants were started. Prothrombim time and activated thromboplastin time test were always normal. We found eight cases with protein S deficiency, three cases with protein C deficiency, two cases with acquired activated protein C resistance (FV Leiden negative), and one patient with lupus anticoagulants. Analysis of demographic, clinical, and therapeutical variables showed that, compared with a historical control group, the only significant change was the use of protease inhibitors. Our results also suggest the association between protease inhibitors and thrombosis in ppatients with AIDS. Prospective studies are necessary in order to confirm this possibility.


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