Racial Comparison of D-Dimer Levels in US Male Military Personnel Before and After HIV Infection and Viral Suppression

• Type of Material: Article
• Authors: Thomas A. O'Bryan, Uniformed Services of the Health Sciences; Brian K. Agan, Uniformed Services of the Health Sciences; Russell P. Tracy, University of Vermont; Matthew S. Freiberg, Vanderbilt University; Jason F. Okulicz, Brooke Army Medical Center; Kaku So-Armah, University of Boston; Anuradha Ganesan, Uniformed Services of the Health Sciences; David Rimland, Emory University; Tahaniyat Lalani, Uniformed Services of the Health Sciences; Robert G. Deiss, Uniformed Services of the Health Sciences; Edmund C. Tramont, National Institute of Allergy and Infectious Diseases
• Language: English
• Date: 2018-04-15
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2018 Wolters Kluwer Health, Inc. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1097/QAI.0000000000001626
• Title of Journal or Parent Work: Journal of Acquired Immune Deficiency Syndromes
• ISSN: 1525-4135
• Volume: 77
• Issue: 5
• Start Page: 502
• End Page: 506
• Grant/Funding Information: Support for this work (IDCRP-000-33) was provided by the Infectious Disease Clinical Research Program (IDCRP, www.idcrp.org), a Department of Defense (DoD) program executed through Uniformed Services University of the Health Sciences.; This project has been funded with federal funds from the National Institute of Allergy and Infectious Diseases, National Institutes of Health (NIH), under Inter-Agency Agreement Y1-AI-5072.
• Keywords: ethnicity; African American; Immunology; MARKERS; Science & Technology; INFLAMMATION; ADULTS; COAGULATION; HIV; AGE; ANTIRETROVIRAL THERAPY; Infectious Diseases; race; Life Sciences & Biomedicine; BIOMARKERS; FUTURE; HAART; AMERICAN; D-dimer
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Immunology

Abstract

Background: D-dimer blood levels in persons with HIV infection are associated with risk of serious non-AIDS conditions and death. Black race has been correlated with higher D-dimer levels in several studies. We examined the effects of race and HIV on D-dimer over time and the impact of viral load suppression by longitudinally comparing changes in levels among healthy young adult male African Americans and whites before HIV seroconversion and before and after initiation of antiretroviral therapy (ART). Methods: We analyzed D-dimer levels and clinical and laboratory data of 192 participants enrolled in the US Military HIV Natural History Study, a 30-year cohort of military personnel infected with HIV. D-dimer levels were measured on stored sera from each participant at 3 time points: (1) before HIV seroconversion (Pre-SC), (2) ≥6 months after HIV seroconversion but before ART initiation (Post-SC), and (3) ≥6 months after ART with documented viral suppression (Post-ART). Levels were compared at each time point using nonparametric and logistic regression analysis. Results: Compared with whites (n = 106), African Americans (n = 86) had higher D-dimer levels post-SC (P = 0.007), but in the same individuals, pre-SC baseline and post-ART levels were similar (P = 0.40 and P = 0.99, respectively). There were no racial differences in CD4 cell counts, HIV RNA viral load, time from estimated seroconversion to ART initiation, and duration on ART. Conclusions: Observed longitudinally, racial differences in D-dimer levels were seen only during HIV viremia. Higher levels of D-dimer commonly observed in African Americans are likely due to factors in addition to race.