Assessment of D-dimer and IL-6 levels in HIV positive individuals at the University Teaching Hospital, Lusaka

Abstract

thrombogenic marker d-dimer are strongly associated with a higher mortality risk in patients with HIV infection. Aims – The aim of the study was to determine if D-Dimer levels in conjunction with IL 6 levels, as markers of predisposition to thrombosis, are higher in HIV positive than in HIV negative indigenous black Zambians. Methods and Results – A prospective cross-sectional study was undertaken at the University Teaching Hospital in Lusaka, Zambia. D-dimers, IL-6, CD4, triglycerides and cholesterol were assessed in HIV positive on ART, HIV positive ART- naïve and HIV negative control participants. Our results showed that HIV ART naïve participants had higher D-dimer (794.71 ± 318.07 ng/ml) and IL-6 concentrations (2.83 ± 1.60 ng/ml) than those on ART (514.39 ± 187.19 ng/ml), (2.49 ± 1.21 ng/ml) p =0.004 and 0.020 respectively. They also had higher d-dimer concentration (794.71 ± 318.07 ng/ml) than the HIV negative control participants (375.08 ± 165.95 ng/ml) p = 0.001. HIV negative control participants however, had higher concentrations of IL-6 (3.24 ± 1.33 ng/ml) than HIV positive participants on ART (2.49 ± 1.21) p = 0.002. IL-6 correlated to d-dimer in HIV positive treatment naïve and HIV negative controls with statistical significance (r = 0.509; p < 0.001 and r = 0.396; p =0.008 respectively). HIV positive participants on ART had higher cholesterol levels (4.87 ± 0.36 mmol/l) than both HIV negative control (4.27 ± 0.32 mmol/l) and HIV positive ART naïve participants (3.78 ± 0.34 mmol/l) p = 0.022 and p < 0.001 respectively. Triglyceride levels correlated to d-dimer levels in HIV positive ART naïve participants with statistical significance (r = 0.332; p < 0.020). However, there was no statistically significant correlation between CD4 and D-dimer in both the HIV positive ART naïve and HIV positive on ART participants (r = 0.064; p = 0.744 and r = 0.019; p =0.904 respectively). Conclusion – This study showed that the levels of IL-6 and d-dimers were higher in HIV positive ART naïve individuals. This in part explains why they are more at risk of cancers, thrombosis and cardiovascular diseases which contribute to a high mortality rate in this group of individuals.