Platelet activation in adult HIV-infected patients on antiretroviral therapy: a systematic review and meta-analysis.

Abstract:

BACKGROUND:Antiretroviral therapy (ART) alters platelet reactivity, and as a consequence, patients living with HIV may be at an increased risk of cardiovascular disease (CVD). The current evidence on platelet activation levels in patients with HIV remains inconclusive. We therefore aimed to systematically synthesise evidence on the association of platelet activation in HIV-infected patients on successful treatment. METHODS:Electronic databases were searched from inception until November 2019. Studies were included if the primary or secondary outcome of the study was to assess platelet activation in HIV-infected patients on ART. The primary outcome of this review included the levels of platelet activation. The pooled effect estimates were calculated using a random-effects meta-analysis model. RESULTS:We identified 30 studies comprising of 2325 participants. The pooled estimates showed elevated levels of platelet activation in treatment-naïve HIV-infected patients compared to uninfected controls (Hedges' g 2.00 [95%CI 1.05, 2.94]; z = 4.12, p < 0.0001). These remained elevated despite successful ART (Hedges' g 2.05 [95%CI 0.58, 3.52]; z = 2.71, p = 0.0067). CONCLUSION:The levels of platelet activation are elevated in treatment-naïve HIV-infected patients, and these persist during successful ART. Further studies should assess the clinical relevance of monitoring the levels of platelet activation in HIV-infected patients on ART.

journal_name

BMC Med

journal_title

BMC medicine

authors

Nkambule BB,Mxinwa V,Mkandla Z,Mutize T,Mokgalaboni K,Nyambuya TM,Dludla PV

doi

10.1186/s12916-020-01801-9

subject

Has Abstract

pub_date

2020-11-18 00:00:00

pages

357

issue

1

issn

1741-7015

pii

10.1186/s12916-020-01801-9

journal_volume

18

pub_type

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