NYMC Faculty Publications
Association of Hepatitis C With Markers of Hemostasis in HIV-Infected and Uninfected Women in the Women's Interagency HIV Study (WIHS)
Author Type(s)
Faculty
DOI
10.1097/QAI.0b013e31827fdd61
Journal Title
Journal of Acquired Immune Deficiency Syndromes
First Page
301
Last Page
310
Document Type
Article
Publication Date
3-1-2013
Department
Biostatistics
Second Department
Public Health
Keywords
Adult, Biomarkers, Coinfection, Cross-Sectional Studies, Factor VIII, Female, Fibrin Fibrinogen Degradation Products, HIV Infections, Hemostasis, Hepatitis C, Humans, Plasminogen Activator Inhibitor 1, Prospective Studies, Protein S, Regression Analysis, United States
Disciplines
Medical Biomathematics and Biometrics | Medicine and Health Sciences | Other Public Health | Women's Health
Abstract
BACKGROUND: Coinfection with HIV and hepatitis C virus (HCV) is common. HIV infection and treatment are associated with hypercoagulability; thrombosis in HCV is underinvestigated. Proposed markers of hemostasis in HIV include higher D-dimer, Factor VIII%, and plasminogen activator inhibitor-1 (PAI-1) antigen and lower total Protein S% (TPS) but have not been examined in HCV. We assessed the independent association of HCV with these 4 measures of hemostasis in a multicenter, prospective study of HIV: the Women's Interagency HIV Study.
METHODS: We randomly selected 450 HCV-infected (anti-HCV+ with detectable plasma HCV RNA) and 450 HCV-uninfected (anti-HCV-) women. HCV was the main exposure of interest in regression models.
RESULTS: Four hundred forty-three HCV+ and 425 HCV- women were included. HCV+ women had higher Factor VIII% (124.4% ± 3.9% vs. 101.8% ± 3.7%, P < 0.001) and lower TPS (75.7% ± 1.1% vs. 84.3% ± 1.1%,
CONCLUSIONS: HCV was independently associated with higher Factor VIII% and lower TPS consistent with hypercoagulability. Higher Factor VIII% and D-dimer and lower TPS were also strongly associated with HIV infection and levels of HIV viremia, independent of HCV infection. Further investigation is needed to determine if there is increased thrombotic risk from HCV. Studies examining hemostasis markers in HIV infection must also assess the contribution of HCV infection.
Recommended Citation
Kiefer, E., Shi, Q., Hoover, D., Kaplan, R., Tracy, R., Augenbraun, M., Liu, C., Nowicki, M., Tien, P., Cohen, M., Golub, E., & Anastos, K. (2013). Association of Hepatitis C With Markers of Hemostasis in HIV-Infected and Uninfected Women in the Women's Interagency HIV Study (WIHS). Journal of Acquired Immune Deficiency Syndromes, 62 (3), 301-310. https://doi.org/10.1097/QAI.0b013e31827fdd61
