Background Patients infected with the human immunodeficiency virus (HIV) are more prone to systemic inflammation and pathological clotting, and many may develop deep vein thrombosis (DVT) as a result of this dysregulated inflammatory profile. Coagulation tests are not routinely performed unless there is a specific reason. Methods We recruited ten healthy control subjects, 35 HIV negative patients with deep vein thrombosis (HIV negative-DVT), and 13 HIV patients with DVT (HIV positive-DVT) on the primary antiretroviral therapy (ARV) regimen-emtricitabine, tenofovir and efavirenz. Serum inflammatory markers, haematological results, viscoelastic properties using thromboelastography (TEG) and scanning electron microscopy (SEM) of whole blood (WB) were used to compare the groups. Results The DVT patients (HIV positive and HIV negative) had raised inflammatory markers. The HIV positive-DVT group had anaemia in keeping with anaemia of chronic disorders. DVT patients had a hypercoagulable profile on the TEG but no significant difference between HIV negative-DVT and HIV positive-DVT groups. The TEG analysis compared well and supported our ultrastructural results. Scanning electron microscopy of DVT patient’s red blood cells (RBCs) and platelets demonstrated inflammatory changes including abnormal cell shapes, irregular membranes and microparticle formation. All the ultrastructural changes were more prominent in the HIV positive-DVT patients. Conclusions Although there were trends that HIV-positive patients were more hypercoagulable on functional tests (viscoelastic profile) compared to HIV-negative patients, there were no significant differences between the 2 groups. The sample size was, however, small in number. Morphologically there were inflammatory changes in patients with DVT. These ultrastructural changes, specifically with regard to platelets, appear more pronounced in HIV-positive patients which may contribute to increased risk for hypercoagulability and deep vein thrombosis.

中文翻译：

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使用血液学、功能和形态学研究比较 HIV 阳性和 HIV 阴性深静脉血栓形成患者的病理凝血

背景 感染人类免疫缺陷病毒 (HIV) 的患者更容易出现全身炎症和病理性凝血，并且由于这种失调的炎症特征，许多患者可能会发生深静脉血栓形成 (DVT)。除非有特定原因，否则不会常规进行凝血测试。方法 我们招募了 10 名健康对照受试者，35 名 HIV 阴性深静脉血栓患者（HIV 阴性-DVT）和 13 名 HIV 深静脉血栓形成患者（HIV 阳性-DVT）接受初级抗逆转录病毒治疗（ARV）方案——恩曲他滨、替诺福韦和依法韦仑。 . 使用全血 (WB) 的血清炎症标志物、血液学结果、使用血栓弹力图 (TEG) 和扫描电子显微镜 (SEM) 的粘弹性特性来比较组。结果 DVT 患者（HIV 阳性和 HIV 阴性）的炎症标志物升高。HIV阳性-DVT组有与慢性疾病性贫血一致的贫血。DVT 患者在 TEG 上具有高凝状态，但 HIV 阴性 DVT 组和 HIV 阳性 DVT 组之间没有显着差异。TEG 分析比较好并支持我们的超微结构结果。DVT 患者的红细胞 (RBC) 和血小板的扫描电子显微镜显示炎症变化，包括异常细胞形状、不规则膜和微粒形成。所有超微结构变化在 HIV 阳性 DVT 患者中更为突出。结论 尽管与 HIV 阴性患者相比，HIV 阳性患者在功能测试（粘弹性曲线）中存在更高的高凝状态，两组之间没有显着差异。然而，样本数量很少。在形态学上，DVT 患者存在炎症变化。这些超微结构的变化，特别是血小板的变化，在 HIV 阳性患者中显得更为明显，这可能会导致高凝状态和深静脉血栓形成的风险增加。