The pathogenesis of hypercoagulability in HIV infection is multifactorial and usually more than one factor is responsible for a thromboembolic episode. The present study was conducted to evaluate the effect of HIV infection and antiretroviral therapy on various coagulation parameters in paediatric patients. Forty two newly diagnosed paediatric patients with HIV infection who were enrolled at the Anti-Retro viral Therapy (ART) centre of Kalawati Saran Children’s Hospital were included in the study. The patients were grouped into 4 clinical stages according to the WHO clinical staging of HIV disease. Coagulation tests [PT, aPTT, fibrinogen, D-Dimer and coagulation inhibitors i.e. Protein C (PC), Protein S (PS) and antithrombin III (AT III), Lupus anticoagulant (LA) and Anti phospholipid antibody (APLA)] were performed in all the patients at the time of diagnosis and repeated after 6 months. All the patients were started on antiretroviral therapy within 2 months of their diagnosis. At the time of diagnosis, prolonged PT and aPTT were observed in 30.9% and 23% of the cases respectively. Hyperfibinogenemia was seen in 11.9% of patients. D-Dimer was raised in 83.3% of patients. PS, PC & AT activities were reduced in 90.4%, 42.8% & 11.9% of cases respectively. A reduction in the PC and AT activity was seen from clinical stage 1 to 4, but the change was not statistically significant. On follow up after 6 months, a statistically significant reduction in the level of fibrinogen and D-Dimer was seen. Even though there was improvement in the activity of all the coagulation inhibitor after 6 months, statistically significant improvement was seen only for PS. The current study shows that HIV produces a hypercoagulable state in children. Raised d-dimer level and deficiency of natural anticoagulants contribute to the thrombophilic state.

HIV 感染中高凝状态的发病机制是多因素的，通常不止一个因素导致血栓栓塞事件。本研究旨在评估 HIV 感染和抗逆转录病毒治疗对儿科患者各种凝血参数的影响。42 名在 Kalawati Saran 儿童医院抗逆转录病毒治疗 (ART) 中心就诊的新诊断为 HIV 感染的儿科患者被纳入该研究。根据 HIV 疾病的 WHO 临床分期，将患者分为 4 个临床阶段。凝血试验 [PT、aPTT、纤维蛋白原、D-二聚体和凝血抑制剂，即蛋白 C (PC)、蛋白 S (PS) 和抗凝血酶 III (AT III)，所有患者在诊断时均进行了狼疮抗凝物 (LA) 和抗磷脂抗体 (APLA) 检测，并在 6 个月后重复检测。所有患者均在诊断后 2 个月内开始接受抗逆转录病毒治疗。在诊断时，分别有 30.9% 和 23% 的病例观察到 PT 和 aPTT 延长。11.9% 的患者出现高纤维蛋白原血症。83.3% 的患者 D-二聚体升高。PS、PC 和 AT 活动分别在 90.4%、42.8% 和 11.9% 的病例中减少。从临床阶段 1 到 4，PC 和 AT 活动有所减少，但变化无统计学意义。在 6 个月后的随访中，观察到纤维蛋白原和 D-二聚体水平的统计学显着降低。尽管 6 个月后所有凝血抑制剂的活性都有改善，但仅 PS 有统计学意义的改善。目前的研究表明，艾滋病毒会使儿童处于高凝状态。d-二聚体水平升高和天然抗凝血剂缺乏会导致血栓形成倾向。