Association of hepatitis C with markers of hemostasis in hiv-infected and uninfected women in the Women's interagency HIV study (WIHS)

Elizabeth M. Kiefer, Qiuhu Shi, Donald R. Hoover, Robert C. Kaplan, Russell Tracy, Michael Augenbraun, Chenglong Liu, Marek Nowicki, Phyllis C. Tien, Mardge Cohen, Elizabeth T. Golub, Kathryn Anastos

Research output: Contribution to journalArticle

4 Citations (Scopus)

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-HCV2) 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%, < 0.001) than HCV- women, independent of HIV infection and viral load; there was little difference in PAI-1 or log10 D-dimer. After adjustment for confounders, these inferences remained. HIV infection was independently associated with higher Factor VIII% and log10 D-dimer and lower TPS. 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.

Original languageEnglish (US)
Pages (from-to)301-310
Number of pages10
JournalJournal of Acquired Immune Deficiency Syndromes
Volume62
Issue number3
DOIs
StatePublished - Mar 1 2013

Fingerprint

Hepatitis C
Hemostasis
Hepacivirus
HIV
Protein S
Factor VIII
HIV Infections
Thrombophilia
Plasminogen Activator Inhibitor 1
Virus Diseases
Viremia
Viral Load
Coinfection
Multicenter Studies

Keywords

  • Coagulation
  • Coinfection
  • Hepatitis C
  • HIV
  • Thrombosis

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Association of hepatitis C with markers of hemostasis in hiv-infected and uninfected women in the Women's interagency HIV study (WIHS). / Kiefer, Elizabeth M.; Shi, Qiuhu; Hoover, Donald R.; Kaplan, Robert C.; Tracy, Russell; Augenbraun, Michael; Liu, Chenglong; Nowicki, Marek; Tien, Phyllis C.; Cohen, Mardge; Golub, Elizabeth T.; Anastos, Kathryn.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 62, No. 3, 01.03.2013, p. 301-310.

Research output: Contribution to journalArticle

Kiefer, Elizabeth M. ; Shi, Qiuhu ; Hoover, Donald R. ; Kaplan, Robert C. ; Tracy, Russell ; Augenbraun, Michael ; Liu, Chenglong ; Nowicki, Marek ; Tien, Phyllis C. ; Cohen, Mardge ; Golub, Elizabeth T. ; Anastos, Kathryn. / Association of hepatitis C with markers of hemostasis in hiv-infected and uninfected women in the Women's interagency HIV study (WIHS). In: Journal of Acquired Immune Deficiency Syndromes. 2013 ; Vol. 62, No. 3. pp. 301-310.
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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-HCV2) 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{\%}, < 0.001) than HCV- women, independent of HIV infection and viral load; there was little difference in PAI-1 or log10 D-dimer. After adjustment for confounders, these inferences remained. HIV infection was independently associated with higher Factor VIII{\%} and log10 D-dimer and lower TPS. 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.",
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T1 - Association of hepatitis C with markers of hemostasis in hiv-infected and uninfected women in the Women's interagency HIV study (WIHS)

AU - Kiefer, Elizabeth M.

AU - Shi, Qiuhu

AU - Hoover, Donald R.

AU - Kaplan, Robert C.

AU - Tracy, Russell

AU - Augenbraun, Michael

AU - Liu, Chenglong

AU - Nowicki, Marek

AU - Tien, Phyllis C.

AU - Cohen, Mardge

AU - Golub, Elizabeth T.

AU - Anastos, Kathryn

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N2 - 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-HCV2) 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%, < 0.001) than HCV- women, independent of HIV infection and viral load; there was little difference in PAI-1 or log10 D-dimer. After adjustment for confounders, these inferences remained. HIV infection was independently associated with higher Factor VIII% and log10 D-dimer and lower TPS. 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.

AB - 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-HCV2) 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%, < 0.001) than HCV- women, independent of HIV infection and viral load; there was little difference in PAI-1 or log10 D-dimer. After adjustment for confounders, these inferences remained. HIV infection was independently associated with higher Factor VIII% and log10 D-dimer and lower TPS. 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.

KW - Coagulation

KW - Coinfection

KW - Hepatitis C

KW - HIV

KW - Thrombosis

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JO - Journal of Acquired Immune Deficiency Syndromes

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