Effect of HAART on Plasminogen Activator Inhibitor-1 Levels and Fibrinolysis in People Living with HIV/AIDS (PLWHA) in Owo, South-West Nigeria

Adedire, Adeyinka; Adeoye, Felix Abayomi; Muhibi, Musa Abidemi; Olaniyan, Mathew Folaranmi; Odegbemi, Odekunle Bola

doi:10.21608/mid.2024.311254.2148

Effect of HAART on Plasminogen Activator Inhibitor-1 Levels and Fibrinolysis in People Living with HIV/AIDS (PLWHA) in Owo, South-West Nigeria

Articles in Press

Document Type : Original Article

Authors

¹ Medical Laboratory Science Department, Edo State University, Uzairue, Edo State, Nigeria

² Medical Laboratory Science Department, Nigerian Navy Hospital, Warri, Delta State, Nigeria

10.21608/mid.2024.311254.2148

Abstract

Background: Highly Active Antiretroviral Therapy (HAART) has markedly enhanced the survival and life quality of people living with HIV/AIDS (PLWHA). However, its influence on hemostasis, specifically on Plasminogen Activator Inhibitor-1 (PAI-1) levels and fibrinolysis, remains understudied. This study explores the effects of HAART on PAI-1 levels and fibrinolysis in PLWHA in Owo, South-West Nigeria. Methods: Ninety participants were recruited, comprising 30 HAART-naïve HIV-positive adults, 30 HIV-positive adults on HAART, and 30 HIV-negative controls. Plasma samples were analyzed for Euglobin Clot Lysis Time (ECLT), D-Dimer, tissue-type Plasminogen Activator (tPA), and PAI-1 levels using ELISA methods. Ethical approval was obtained from the Health Research Ethics Committee of Federal Medical Centre, Owo. Results: PAI-1 levels were significantly lower in the HAART group (2.25±0.54) compared to the HAART-naïve group (3.23±0.77) (P<0.001). Participants on HAART exhibited higher mean tPA values (19.62±13.75) compared to HAART-naïve (8.22±4.14) and HIV-negative controls (6.64±3.10) (P<0.001). ECLT was reduced in the HAART group (156.87±89.22) versus HAART-naïve (234.20±72.95) and controls (223.30±45.27) (P<0.001). Significant differences in D-Dimer levels were observed among HAART participants (356.37±176.35), HAART-naïve (364.17±93.93), and controls (230.70±89.53) (P<0.001). Conclusion: HAART appears to induce hyperfibrinolysis, characterized by decreased PAI-1 levels and enhanced tPA activity. The observed alterations in fibrinolytic markers may reflect endothelial dysfunction and a hypercoagulable state, potentially increasing the risk of bleeding complications in PLWHA on HAARTز

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