HIV and Thromboembolic Disease

The thromboembolic disease occurs when a blood clot, or a thrombus, forms in a blood vessel and travels through the bloodstream. The blood clot can then plug other vessels that lead to important organs such as the lungs, kidneys, gastrointestinal tract, legs and brain. Since HIV patients have started living longer, doctors have discovered a link between HIV and abnormal blood clotting, which is also known as hypercoagulability. For this reason, people living with HIV may be more prone to thromboembolic disease than the general population.

Prevalence of thromboembolic disease in people living with HIV

The thromboembolic disease often occurs when a patient is healing from a traumatic injury or surgery; however, some HIV patients develop abnormal blood clots when they otherwise seem healthy. The underlying reason for this is unknown, but researchers have identified a few abnormalities in HIV patients’ blood that heighten the risk of blood clotting, such as high levels of adhesion molecules and deficiencies in specific proteins.

Preventing blood clots in patients living with HIV

Like all illnesses related to the heart and blood, recommendations for preventing thromboembolic disease include general measures for promoting good cardiac health such as:

• Regular aerobic exercise several times a week
• Avoid sitting for long periods
• Maintain a healthy weight
• Don’t use tobacco products

Treatment of thromboembolic disease in people living with HIV

Thromboembolic disease is usually treated with medication, mechanical devices, or a combination of the two. Automated treatment methods include wearing graduated compression stockings and using manual compression devices to promote blood flow and prevent stasis.

Oral anticoagulants can be highly effective at treating thromboembolic disease, but doctors should use extreme caution when prescribing anticoagulants to patients with HIV because of potential interactions with antiretroviral medications. So far, nine cases of adverse interactions between anticoagulants and antiretrovirals have been documented. Documented drug interactions involving antiretrovirals can be found at http://www.hiv-druginteractions.org/Interactions.aspx. Even if no interaction is suspected, patients should be regularly monitored while combining treatments.

In sporadic cases, surgery may be recommended to remove a blood clot; however, surgery increases the risk of developing future blood clots, so surgery is customarily reserved for immediately life-threatening circumstances.