Key result
Deep-vein thrombosis is linked to high infection rates, with HIV present in ~53% of patients.
Why the study?
The impact of high HIV and tuberculosis prevalence on venous thromboembolic disease characteristics and management in South Africa was not well defined in the pre-DOAC era.
Cohort (n=99)
No
Answers are grounded in this paper and cite their sources.
High HIV/TB prevalence in DVT patients may support screening in endemic areas; leaves open causal links and need for prospective studies.
BACKGROUND: Venous thromboembolic disease (VTE) is a leading cause of morbidity and mortality worldwide. HIV and tuberculosis (TB) infections have an aetiological association with VTE. Implementation of national HIV and TB programmes in South Africa (SA) has changed the burden of these two conditions, with resultant effects on VTE prevalence. Furthermore, with the increased use of direct oral anticoagulants (DOACs), baseline thrombosis data are needed to evaluate the effect of these new agents. OBJECTIVES: To determine real-life baseline VTE characteristics in a pre-DOAC era, and to document the association of HIV and TB infections with VTE. METHODS: This was a single-centre prospective cohort study performed in a quaternary care centre at Charlotte Maxeke Johannesburg Academic Hospital, SA. Key inclusion criteria included signed informed consent by adults (≥18 years) with a new episode of thrombosis. Procedures included physical examination, thrombosis risk factor assessment, duplex Doppler examination, thrombophilia screening, inpatient treatment and outpatient follow-up. RESULTS: Ninety-nine participants with confirmed thrombosis met the inclusion criteria. Participants were predominantly black (79.8%) and female (64.6%), with a median age of 46 (interquartile range (IQR) 38 - 57) years. The prevalences of HIV and TB were 53.0% and 21.2%, respectively. The most common risk factors for thrombosis were TB (17.2%) and malignancies (14.1%). Thrombophilia screening had a low diagnostic yield. The median time to target international normalised ratio during hospitalisation was 5.5 (IQR 4.0 - 7.0) days and the median duration of hospitalisation was 9 (IQR 7 - 11) days. The overall mortality rate in the cohort at 3 months post hospitalisation was 12.1%. CONCLUSIONS: This prospective study provides real-life data on thrombosis diagnosis and management at a quaternary public healthcare facility, providing a valuable baseline against which the effect of new DOAC anticoagulants can be assessed. Further research is required to clarify the aetiological association between thrombosis and HIV and TB.
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Hodkinson et al. (2017) conducted a cohort in Deep-vein thrombosis (n=99). HIV and TB infection vs. Uninfected patients was evaluated on Prevalence of HIV and TB. Among 99 patients presenting with deep-vein thrombosis, the prevalence of HIV was 53.0% and tuberculosis was 21.2%, highlighting a high burden of these infections in thrombosis patients.
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