Venous thromboembolic disease in the HIV-infected patient

Am J Emerg Med. 2011 Mar;29(3):278-82. doi: 10.1016/j.ajem.2009.09.034. Epub 2010 Mar 26.

Abstract

Objective: Infection with the HIV has developed into a chronic illness, with longer-term complications increasingly being seen. There is increasing evidence that infection with HIV may be associated with a hypercoagulable state. This study examines the association of HIV infection with the incidence of both pulmonary embolism and deep venous thrombosis.

Methods: This study was a weighted analysis of data from National Hospital Discharge Survey, a national annual probability survey of discharges from short-stay non-Federal hospitals, from 1996-2004. The risk of pulmonary embolism and/or deep venous thrombosis in an HIV+ individual was ascertained for each age group by calculation of an odds ratio (OR) with a 95% confidence interval (CI). A common OR was computed across strata to evaluate the overall association between PE/DVT and HIV while adjusting for effects of age.

Results: The overall age-adjusted OR indicates a statistically significant increase of 43% for PE in HIV+ individuals as opposed to HIV- individuals (OR, 1.43; 95% CI, 1.39-1.46). This increase differs by age group, with age group 21 to 50 years having the highest odds for PE among HIV+ individuals (OR, 1.58; 95% CI, 1.54-1.63).

Conclusions: The data supports the hypothesis that HIV-infected individuals are more likely to have clinically detected thromboembolic disease as opposed to non-HIV-infected individuals. This study reveals up to a 43% increase in OR of developing a PE, 10% increase in developing a DVT, and 40% increase in developing PE or DVT in an HIV-infected individual over the 9-year study period after adjusting for age.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Confidence Intervals
  • Female
  • HIV Infections / complications*
  • Hospitalization / statistics & numerical data
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Odds Ratio
  • Pulmonary Embolism / epidemiology
  • Pulmonary Embolism / etiology
  • Risk Factors
  • United States
  • Venous Thromboembolism / epidemiology
  • Venous Thromboembolism / etiology*
  • Venous Thrombosis / epidemiology
  • Venous Thrombosis / etiology
  • Young Adult