<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article  PUBLIC "-//NLM//DTD Journal Publishing DTD v3.0 20080202//EN" "http://dtd.nlm.nih.gov/publishing/3.0/journalpublishing3.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="3.0" xml:lang="en" article-type="research article"><front><journal-meta><journal-id journal-id-type="publisher-id">JBM</journal-id><journal-title-group><journal-title>Journal of Biosciences and Medicines</journal-title></journal-title-group><issn pub-type="epub">2327-5081</issn><publisher><publisher-name>Scientific Research Publishing</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.4236/jbm.2016.410001</article-id><article-id pub-id-type="publisher-id">JBM-71062</article-id><article-categories><subj-group subj-group-type="heading"><subject>Short Report</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Biomedical&amp;Life Sciences</subject></subj-group></article-categories><title-group><article-title>
 
 
  Estimation and Assessment of Plasma D-Dimer Levels in HIV Patients
 
</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Wafa</surname><given-names>Hamid Haroun Himmat</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Nasr</surname><given-names>Eldeen Ali Mohammed Gaufri</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib></contrib-group><aff id="aff1"><addr-line>Faculty of Medical Laboratory Sciences, Al Neelain University, Khartoum, Sudan</addr-line></aff><author-notes><corresp id="cor1">* E-mail:<email>nasralimohammed@yahoo.com(NEAMG)</email>;</corresp></author-notes><pub-date pub-type="epub"><day>30</day><month>09</month><year>2016</year></pub-date><volume>04</volume><issue>10</issue><fpage>1</fpage><lpage>5</lpage><history><date date-type="received"><day>August</day>	<month>3,</month>	<year>2016</year></date><date date-type="rev-recd"><day>Accepted:</day>	<month>September</month>	<year>27,</year>	</date><date date-type="accepted"><day>September</day>	<month>30,</month>	<year>2016</year></date></history><permissions><copyright-statement>&#169; Copyright  2014 by authors and Scientific Research Publishing Inc. </copyright-statement><copyright-year>2014</copyright-year><license><license-p>This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/</license-p></license></permissions><abstract><p>
 
 
  <b>Background</b>: The elevation of plasma D-dimer levels is fully described and associated with the increase of the mortality of patients with HIV. The present study was aimed to estimate and assess the plasma D-dimer levels in HIV patient. 
  <b>Material and Methods</b>: A case control study done in May 2015. A total of 100 subjects were enrolled in this study; 50 were patients professionally diagnosed by HIV; 25 (50%) were males and 25 (50%) were females; their mean age is 35 years. Further 50 normal healthy individuals as normal control group: their gender and age were matched with patient groups. The platelets poor plasma (PPP) was immediately prepared from citrated blood, then the plasma D-dimer level was measured using (MISPA-i
  <sub>2</sub> Reagent) Switzerland. Data were analyzed using statistical packing for social sciences program (SPSS) 20. 
  <b>Results</b>: The D-dimer levels was significantly higher in patient with HIV compared with the normal healthy control group (Mean and STD 502.2 &#177; 287.8 vs 251.8 &#177; 152.7 
  P. value 0.01). 
  <b>Conclusion</b>: The D-dimer level was significantly higher in patient with HIV compared with those in normal healthy control group.
 
</p></abstract><kwd-group><kwd>HIV</kwd><kwd> AIDS</kwd><kwd> D-Dimer</kwd><kwd> Sudan</kwd></kwd-group></article-meta></front><body><sec id="s1"><title>1. Introduction</title><p>HIV is lentivirus (sub group of retrovirus) that causes HIV infection and acquires immunodeficiency syndrome (AIDS) [<xref ref-type="bibr" rid="scirp.71062-ref1">1</xref>] [<xref ref-type="bibr" rid="scirp.71062-ref2">2</xref>] . AIDS is a condition in humans in which progressive failure of the immune system allows life-threating opportunistic infections and cancers to thrive without treatment average survival time after infection with HIV is estimated to be 9 to 11 years depending on the HIV subtype [<xref ref-type="bibr" rid="scirp.71062-ref3">3</xref>] . HIV infects vital cells in the human immune system such as helper T cells (specifically CD4+ T cells), macrophages, and dendritic cells [<xref ref-type="bibr" rid="scirp.71062-ref4">4</xref>] . The infection of HIV leads to low levels of CD4+ Tcells through a number of mechanisms, including pyroptosis of abortively infected T cells [<xref ref-type="bibr" rid="scirp.71062-ref5">5</xref>] , direct viral killing of infected cells, and killing of infected CD4+ T cells by CD8 cytotoxic lymphocytes that recognize infected cells [<xref ref-type="bibr" rid="scirp.71062-ref6">6</xref>] . Infection with HIV occurs by the transfer of, blood, semen, vaginal fluid, pre-ejacute, or breast milk. It is a global pandemic [<xref ref-type="bibr" rid="scirp.71062-ref7">7</xref>] . As of 2012 approximately 35.5 million people are living with HIV globally, of these approximately 17.2 million are men, 16.8 million are women and 3.4 million are less than 15 years old [<xref ref-type="bibr" rid="scirp.71062-ref8">8</xref>] [<xref ref-type="bibr" rid="scirp.71062-ref9">9</xref>] . Sub-Saharan Africa has the most serious HIV and AIDS epidemic in the world. In 2013, an estimated 24.7 million people were living with HIV, accounting for 71% of the global total. In the same year, there were an estimated 1.5 million new HIV infections and 1.1 million AIDS-related deaths [<xref ref-type="bibr" rid="scirp.71062-ref10">10</xref>] .</p><p>As reported in SMART study, the hypercoagulable state was associated with the disease mortality and may be considered as one of causes that lead to death in HIV disease [<xref ref-type="bibr" rid="scirp.71062-ref11">11</xref>] . Several studies confirm the SMART study in fact that the D-dimers has a strong correlated with cardiovascular disease [<xref ref-type="bibr" rid="scirp.71062-ref12">12</xref>] . D-dimer levels forecast the present of throm- bosis whatever venous or arterial in all individuals and with those affected by HIV infection [<xref ref-type="bibr" rid="scirp.71062-ref3">3</xref>] [<xref ref-type="bibr" rid="scirp.71062-ref12">12</xref>] - [<xref ref-type="bibr" rid="scirp.71062-ref18">18</xref>] . The mechanism of present hypercoagulability which detected by D-dimer and pathophysiology of HIV were still unclear; even though many researchers reported the endothelial damage and vascular dysfunction [<xref ref-type="bibr" rid="scirp.71062-ref19">19</xref>] - [<xref ref-type="bibr" rid="scirp.71062-ref21">21</xref>] .</p></sec><sec id="s2"><title>2. Material and Methods</title><p>This is a case control study done in May 2015. A total of 100 subjects were enrolled in this study. 50 were patients professionally diagnosed with HIV, 25 (50%) were males and 25 (50%) were females; their mean age is 35 years. Further 50 normal healthy used as control groups their gender and age was matched with patient groups. This study was approved from Alneelain university ethical committee, the consent was also taken from all participant enrolled in this study before the samples were collected. Then 3 ml of venous blood were collected in a container contains 3.2% trisodium citrate at a ratio of 9:1 as anticoagulant, then platelets poor plasma (PPP) was immediately prepared by centrifuged for 15 minutes at 3000 rpm. The plasma D-dimer levels were measured by using (MISPA-i<sub>2</sub> Reagent) Switzerland. Every patient with a history of thrombosis and liver disease excluded from this study. Data analyzed by statistical packing for social sciences program (SPSS) 20. A value of less than 0.05 was considered significant.</p></sec><sec id="s3"><title>3. Results</title><p>The present study showed that the D-dimer level was significant increased in patient with HIV when compared with the normal healthy control group (Mean and STD were 502.2 &#177; 287.8 vs 251.8 &#177; 152.7 P. value 0.01) respectively (<xref ref-type="table" rid="table1">Table 1</xref>).</p><table-wrap id="table1" ><label><xref ref-type="table" rid="table1">Table 1</xref></label><caption><title> Correlation of D-dimer levels HIV patient versus normal control group</title></caption><table><tbody><thead><tr><th align="center" valign="middle" >parameters</th><th align="center" valign="middle" >subjects</th><th align="center" valign="middle" >numbers</th><th align="center" valign="middle" >Means &#177; SD</th><th align="center" valign="middle" >P value</th></tr></thead><tr><td align="center" valign="middle" >D-dimerNg/mg</td><td align="center" valign="middle" >patient Control</td><td align="center" valign="middle" >50 50</td><td align="center" valign="middle" >502.2 &#177; 287.8 251.8 &#177; 152.7</td><td align="center" valign="middle" >0.01</td></tr></tbody></table></table-wrap></sec><sec id="s4"><title>4. Discussion</title><p>Haemostatic abnormalities in coagulation factor levels and a hypercoagulable state in HIV-positive individuals have been reported years ago [<xref ref-type="bibr" rid="scirp.71062-ref22">22</xref>] - [<xref ref-type="bibr" rid="scirp.71062-ref24">24</xref>] . Exactly like any other chronic inflammation HIV infection associated with activated coagulation system [<xref ref-type="bibr" rid="scirp.71062-ref25">25</xref>] - [<xref ref-type="bibr" rid="scirp.71062-ref27">27</xref>] . D-dimer test is a common test used to diagnosis the present of thromboembolic disorders; it’s defined by a fibrin degradation product, which is the most predictive biomarker of overall mortality in HIV patients [<xref ref-type="bibr" rid="scirp.71062-ref28">28</xref>] [<xref ref-type="bibr" rid="scirp.71062-ref29">29</xref>] . D-dimer also has the probable to recognize subgroups warrant primary prophylaxis or prolonged anticoagulation [<xref ref-type="bibr" rid="scirp.71062-ref30">30</xref>] [<xref ref-type="bibr" rid="scirp.71062-ref31">31</xref>] . To our acquaintance, this is the first study to assess the plasma D-di- merin Sudanese HIV patients. This study revealed that the D-dimer levels were significantlyhigher in HIV patients when compared with normal healthy control group (p value 0.01). This Finding was in concordance with study done in 2009 cited by Jacqueline Neuhaus et al. who reported that the higher D-dimer levels was higher in HIV patient when compared with those normal control group [<xref ref-type="bibr" rid="scirp.71062-ref26">26</xref>] . The interesting findings of the current study are also in consistence with several recently studies done in different population in which the authors concluded that the D-dimer levels were significantly higher in patients with acquired immunodeficiency syndrome compared with normal control group [<xref ref-type="bibr" rid="scirp.71062-ref29">29</xref>] - [<xref ref-type="bibr" rid="scirp.71062-ref34">34</xref>] .</p></sec><sec id="s5"><title>5. Conclusion</title><p>Based on our result, this study concluded that the Sudanese patients with HIV infection have hypercoagulable state.</p></sec><sec id="s6"><title>Cite this paper</title><p>Himmat, W.H.H. and Gaufri, N.E.A.M. (2016) Estimation and Assessment of Plasma D-Dimer Levels in HIV Patients. 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