Abacavir use is associated with increased prothrombin conversion

Figures

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  Figure 1. Procoagulant and anticoagulant factors in PLHIV stratified for ABC-based treatment. (A) Although prothrombin levels in PLHIV were lower than uninfected controls, prothrombin levels did not differ between PLHIV with an ABC-based treatment or a non-ABC-based treatment. (B-D) Fibrinogen (B), antithrombin (C) and α2-macroglobulin (D) levels were comparable between ABC-based and non-ABC-based treated PLHIV, and between PLHIV and uninfected controls. Data of PLHIV participants with and without ABC-based treatment are represented as dots with green bars indicating the group median and interquartile range. For comparison, the median of the controls without HIV is shown as a black dashed line and the interquartile range is depicted as a grey box. ABC, abacavir; ETP, endogenous thrombin potential; PLHIV, people living with HIV;.

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  Figure 2. Von Willebrand factor as a biomarker of endothelial wall function in PLHIV, stratified for ABC treatment. (A-C) Von Willebrand Factor (A), active Von Willebrand Factor (B) and Von Willebrand Factor pro-peptide (C) levels did not differ between PLHIV on ABC-based or non-ABC-based treatment, and between PLHIV and controls without HIV. Data of PLHIV with and without ABC-based treatment are represented as dots with green bars indicating the group median and interquartile range. For comparison, the median of the controls without HIV is shown as a black dashed line and the interquartile range is depicted as a grey box. ABC, abacavir; PLHIV, people living with HIV; VWF; Von Willebrand Factor.

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  Figure 3. Prothrombin conversion curves in PLHIV and controls without HIV. (A) The median prothrombin conversion curves in controls without HIV with the 95% confidence interval marked as grey shading. The quantification of prothrombin conversion parameters PCtot (area-under-the-curve, green) and PCmax (peak height of the curve) are indicated. (B) The median prothrombin conversion curves in PLHIV on ABC treatment (green) and PLHIV on other treatment regimens (purple), each with their 95% confidence interval depicted as shading. The 95% confidence interval of the controls without HIV is indicated in grey for comparison.

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  Figure 4. The dynamics of thrombin generation in PLHIV, stratified for ABC treatment. (A) The total amount of prothrombin converted was significantly higher in PLHIV on ABC treatment compared to other treatment regimes. (B) The maximum rate of prothrombin activation by the prothrombinase complex showed significantly higher rates in ABC treated individuals. (C) Thrombin-antithrombin complex formation was significantly higher in ABC treated participants compared to participants on other treatment regimes. (D) Thrombin-α2-macroglobulin complex formation did not differ between ABC treated participants and participants on other treatment regimes. Data of PLHIV participants with and without ABC treatment are represented as dots with green bars indicating the group median and interquartile range. For comparison, the median of the controls without HIV is shown as a black dashed line and the interquartile range is depicted as a grey box. ***P<0.001 and *p<0.05 according to the Mann-Whitney test.

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  Figure 5. Natural anticoagulant activity in PLHIV, stratified for ABC treatment. The thrombin decay capacity does not differ between PLHIV treated with ABC or another treatment regime. The data of PLHIV participants with and without ABC treatment is represented as dots with green bars indicating the group median and interquartile range. For comparison, the median of the controls without HIV is shown as a black dashed line and the interquartile range is depicted as a grey box.