Effect of HIV Infection and Antiretroviral Therapy on Some Red Cell Enzyme Activities and Coagulation Parameters

Aim: To assess G-6-PD, Pyruvate kinase enzyme activity and some coagulation parameters in HIV positive patients on antiretroviral treatment (ART) and those not on antiretroviral treatments with varying durations of infection and Antiretroviral treatments.
Study Design: Case-control study
Place and Duration of Study: Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria from March to August 2013.
Methodology: We included 181 subjects; Sixty HIV patients on ART with infection and ART duration of <1 – 5, >5 – 8 and >8 – 17 years; Sixty HIV patients not on ART with an infection duration of <1 – 3, >3 – 6 and >6 – 11 years; and Sixty-one apparently healthy individuals control. Glucose-6-Phosphate Dehydrogenase (G-6-PD) activity, Pyruvate kinase (PK) activity, Activated Partial Thromboplastin time (APTT), Prothrombin time (PT), Platelet count (PLT)and Human Immunodeficiency virus (HIV) status were determined.
Results: G-6-PD, APTT and PT, for ART and non-ART were significantly higher (P< 0.05) compared with those of control. G-6-PD and PT were significantly higher in ART subjects when compared with non-ART (P<0.05). There was no significant difference in Pyruvate kinase activity and platelet count (P>0.05). G-6-PD activity was significantly higher in ART subjects with HIV duration of >8 – 17 years than<1 – 5 years and >5 – 8 years (P< 0.05), and also in non-ART subjects with HIV duration of>3 -6 years and>6 – 11 years compared with<1 – 3 years (P< 0.05). G-6-PD activity was significantly higher in ART duration of>8 – 17 years compared to ART durations of >5 – 8 years and <1 – 5 years (P< 0.05).
Conclusion: This study identified a significant increase in G-6-PD activity in HIV patients in proportion to the duration of infection and therapy while APTT and PT were significantly prolonged in HIV patients implying a derangement in the intrinsic and extrinsic coagulation pathways.