Clinical Characteristics of HIV-Infected Patients with Venous Thromboembolism and Different CD4 T Lymphocyte Levels.

Objective: This study aims to analyze the clinical characteristics of HIV-infected patients complicated with venous thromboembolism (VTE).

Methods: Seventy HIV-infected patients complicated with VTE were enrolled from Beijing Ditan Hospital Capital Medical University from October 2009 to December 2020 and divided into two groups according to CD4. The clinical data of 70 patients were observed, including general conditions, laboratory indexes, viral load, antiretroviral therapy (ART) before the diagnosis of VTE, and thrombus treatment.

Results: The patients were divided into two groups according to the CD4 T lymphocyte count. There were 27 patients with a CD4 T lymphocyte count ≥200 cells/ul, classified as group A (27/70, 38.6%), and there were 43 patients with a CD4 T lymphocyte count <200 cells/ul, classified as group B (43/70, 61.4%). In group B, these patients included 37 males and 6 females. The average age was 47.1±12.1 years old. The average levels of the following indexes were: D-dimer, 3.5 mg/L (0.7, 6.9); total cholesterol, 4.4 mmol/L (3.3, 5.5); triglycerides, 1.4 mmol/L (0.9, 2.0); low density lipoprotein, 1.9 mmol/L (1.5,2.5); albumin, 31.8±6.4 g/L; CD4+, 66 cells/ul (18, 127); viral load, 12347 copies/mL (27, 203936). Sixty-three patients (63/70, 90%) had started highly active ART (HAART) before VTE was diagnosed, 37 patients (37/70, 52.9%) were complicated with bacterial pneumonia, 16 patients had (16/70, 22.9%), 13 patients had pneumonia (PCP) (13/70, 18.6%), and eight patients were complicated with cytomegalovirus (CMV) infection (8/70, 11.4%). Twenty-four patients had tumors, and 15 patients had HIV-related tumors (15/70, 21.4%). There were significant differences between the two groups in the time from the diagnosis of HIV to the discovery of thrombosis, the time from ART to the discovery of thrombosis and bacterial pneumonia, and the differences in WBC, PLT, Hb, CRP, PTA, INR, TCHO, LDL-C, ALB, and viral load were statistically significant.

Conclusion: The prevalence of VTE in HIV-infected people in the last 11 years was 1.4%. In patients with a high viral load, CRP, D-dimer levels, and low CD4 and albumin levels, 11.4-22.9% were complicated with an opportunistic infection, and 21.4% had HIV-related tumors. There were significant differences between the two groups in high viral load, CRP, D-dimer, and low albumin.